Trotot P M, Vazeux R, Yamashita H K, Sandoz-Tronca C, Mikol J, Vedrenne C, Thiébaut J B, Gray F, Cikurel M, Pialoux G
Institut Pasteur, Hôpital, Paris.
J Neuroradiol. 1990;17(4):233-54.
Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease which occurs in immunodepressed subjects and is particularly frequent in AIDS. Some authors having drawn attention to the protean aspect of the disease and claimed that AIDS may lose its basic characteristics and affect the grey matter as well as the white matter, we reviewed a series of 8 patients who had been biopsied and/or autopsied and had been examined at least once by MRI. In this series, contrary to what is regularly observed in toxoplasmic abscesses we did not find any lesion of the grey matter or any mass effect. On the other hand, we confirmed that PLM is not multifocal in all cases and that it course may be interrupted by prolonged remissions. The MRI criteria for PML therefore are reliable, provided multiple T2-weighted slices in coronal plane are performed, clearly showing the anatomy of the white fibres affected. However, it must be borne in mind that HIV-infected patients often have other associated brain pathologies, especially when the immune deficiency increases.
进行性多灶性白质脑病（PML）是一种发生于免疫抑制患者的脱髓鞘疾病，在艾滋病患者中尤为常见。一些作者已关注到该疾病的多变性，并声称艾滋病可能会失去其基本特征，同时累及灰质和白质。我们回顾了一系列8例患者，这些患者均接受了活检和/或尸检，并且至少接受过一次MRI检查。在该系列中，与弓形虫脓肿中经常观察到的情况相反，我们未发现任何灰质病变或占位效应。另一方面，我们证实PML并非在所有病例中都是多灶性的，其病程可能会因长期缓解而中断。因此，只要在冠状面进行多个T2加权层面扫描，清晰显示受影响白质纤维的解剖结构，PML的MRI诊断标准就是可靠的。然而，必须牢记，HIV感染患者常常伴有其他相关脑部病变，尤其是当免疫缺陷加重时。
