|
FIG 2. MR findings in a 31-year-old woman (patient 3) with AIDS who presented initially with headache, slowing of thoughts, aphasia, and impairment in memory. HIV-1 RNA assay revealed high viral load in serum and CSF. Imaging findings were consistent with HIV encephalitis. HAART, including one protease inhibitor, was started.
A and B, Pretreatment axial FSE-FLAIR images (10000/150, TI = 2600) show areas of increased signal intensity at the anterior portions of the external capsules bilaterally, in the right caudate nucleus (curved arrow, A), and periventricular white matter in the frontal, parietooccipital, and central areas bilaterally (straight arrows). Additional lesions are present in both thalami (open arrows, A).
C and D, Six weeks after the initiation of HAART, including protease inhibitors, corresponding axial FSE-FLAIR images (7374/130, TI = 2100) show resolution of the signal intensity abnormalities in the basal ganglia and thalami (C) but progression of the white matter abnormalities (arrows). The patient had improved clinically at that time.
E and F, Seven months after the start of a potent antiretroviral therapy regimen, axial FSE-FLAIR images (7385/130, TI = 2100) at the same level show an interval decrease in the high signal abnormalities within the occipital, parietal (arrows, F), and frontal (arrows, E) white matter.
|