Encephalitis caused by human immunodeficiency virus: CT and MR imaging manifestations with clinical and pathologic correlation

Harris S. Chrysikopoulos, Gary A. Press, Marjorie R. Grafe, John R. Hesselink, Clayton A. Wiley

Research output: Contribution to journalArticle

74 Scopus citations

Abstract

To determine the computed tomographic (CT) and magnetic resonance (MR) imaging manifestations of central nervous system (CNS) infection by the human immunodeficiency virus (HIV), the authors analyzed the results of imaging of the CNS in 24 patients with HIV encephalitis confirmed at autopsy. Careful pathologic correlation demonstrated that neither CT nor MR imaging enabled detection of microglial nodules with multinucleated giant cells, the hallmark of HIV encephalitis seen in all 24 affected patients. The most common abnormality observed on images of the CNS was atrophy, demonstrated in 18 patients. Demyelination and vacuolation of white matter tracts accompanying severe HIV infection caused hypoattenuation on CT scans and hyperintensity on T2-weighted MR images. These lesions had no mass effect. MR imaging was more sensitive than CT in the detection of lesions caused by HIV or other superimposed infectious agents. Although it is often difficult to attribute any radiologic appearance to a single etiologic agent in patients with acquired immunodeficiency syndrome, the combination of atrophy and symmetric, periventricular or diffuse white matter disease suggests HIV encephalitis.

Original languageEnglish (US)
Pages (from-to)185-191
Number of pages7
JournalRADIOLOGY
Volume175
Issue number1
DOIs
StatePublished - Apr 1990

Keywords

  • Brain, CT, 13.1211
  • Brain, MR studies, 13.1214
  • Brain, infection, 13.203, 13.2054, 13.2065, 13.2066, 13.2074
  • Brain, white matter, 13.253
  • Encephalitis, 13.253
  • Kaposi sarcoma, 10.349
  • Viruses, 13.2065, 13.2066

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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