EURORAD ESR

Case 9816

Human immunodeficiency virus (HIV)-associated progressive multifocal leukoencephalopathy (PML) (ECR 2011 Case of the Day)

Author(s)
Thurnher MM, Frühwald-Pallamar J, Puchner S, Fakhrai N

Medical University of Vienna,
Department of Radiology;
Waehringer Guertel 18-20 1090 Vienna, Austria; Email:majda.thurnher@meduniwien.ac.at
 
Patient
male, 40 year(s)
 
 
  • Figure 1
    CCT

    Initial CT examination shows solitary lesion of marked hypodensity in the right hemisphere.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: CT; Procedure: Diagnostic procedure; Special Focus: AIDS;
     
     
  • Figure 2
    Axial FLAIR

    On FLAIR MR image high signal intensity abnormality was detected with no mass effect.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: AIDS;
     
     
  • Figure 3
    Axial DWI

    Low signal is seen on trace DWI (b=1000) centrally with high signal intensity rim observed at the periphery of the lesion.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: AIDS;
     
     
  • Figure 4
    Axial ADC

    High ADC values are measured on an ADC map centrally (elevated diffusivity) with low ADC observed at the periphery of the lesion (restricted diffusion).

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR-Diffusion/Perfusion; Procedure: Diagnostic procedure; Special Focus: AIDS;
     
     
  • Figure 5
    Axial T1WI

    Marked low signal is detected on pre-contrast T1-WI.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: AIDS;
     
     
  • Figure 6
    Axial T1Gad

    On post-contrast T1-WI MR image no enhancement is present.

     
    Area of Interest: Neuroradiology brain; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: AIDS;
     
     
Initial CT examination shows solitary lesion of marked hypodensity in the right hemisphere.
 
On FLAIR MR image high signal intensity abnormality was detected with no mass effect.
 
Low signal is seen on trace DWI (b=1000) centrally with high signal intensity rim observed at the periphery of the lesion.
 
High ADC values are measured on an ADC map centrally (elevated diffusivity) with low ADC observed at the periphery of the lesion (restricted diffusion).
 
Marked low signal is detected on pre-contrast T1-WI.
 
On post-contrast T1-WI MR image no enhancement is present.
 
 
 
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