TY - JOUR T1 - Initial and Follow-up MR Imaging Findings in AIDS-Related Progressive Multifocal Leukoencephalopathy Treated with Highly Active Antiretroviral Therapy JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 977 LP - 984 VL - 22 IS - 5 AU - Majda M. Thurnher AU - M. Judith Donovan Post AU - Armin Rieger AU - Christina Kleibl-Popov AU - Christian Loewe AU - Erwin Schindler Y1 - 2001/05/01 UR - http://www.ajnr.org/content/22/5/977.abstract N2 - BACKGROUND AND PURPOSE: Recent studies have shown the beneficial effect of highly active antiretroviral therapy (HAART) in AIDS-related progressive multifocal leukoencephalopathy (PML). The purpose of our study was to evaluate the initial and follow-up imaging findings and survival in patients with PML who were treated with HAART.METHODS: The clinical course and MR imaging findings on initial and follow-up MR studies in four consecutive AIDS patients with PML who were treated with HAART are described.RESULTS: Two patients were short-term survivors and died after 3 months. Two patients are still alive, with a survival time of 22 and 43 months, respectively. On initial MR studies, more extensive white matter changes were seen in the short-term survivors. Development of a mass effect and temporary enhancement (in one patient) was observed in two HAART responders on follow-up MR studies. Increased hypointensity on T1-weighted images with concomitant low signal on fluid-attenuated inversion-recovery fast spin-echo (FLAIR-FSE) images was seen in two responders, representing leukomalacia. Atrophic changes of the involved areas of the brain, consistent with burnt out PML lesions, were seen in two long-term survivors. In the short-term survivors, increased hypointensity was present on T1-weighted images with increased high signal on FLAIR-FSE images, representing progressive destructive disease.CONCLUSION: Our results suggest that a clinical and radiologic response can be seen in some patients with AIDS-associated PML on HAART while in others there may be no beneficial response. Development of a mass effect and temporary enhancement on MR images in the early phase of treatment might represent positive predictive factors for prolonged survival. ER -