Sakai Mio, Inoue Yusuke, Aoki Shigeki, Sirasaka Takuma, Uehira Tomoko, Takahama Soichiro, Nagai Hideaki, Yutani Kenji, Yoshikawa Kohki, Nakamura Hironobu
Department of Radiology, Osaka University Graduate School of Medicine, 565-0871, Japan.
Jpn J Radiol. 2009 Feb;27(2):69-77. doi: 10.1007/s11604-008-0302-3. Epub 2009 Mar 12.
The aim of this study was to clarify the early magnetic resonance imaging (MRI) findings of progressive multifocal leukoencephalopathy (PML) and to evaluate the relations of the clinical course and serial MRI findings in patients with acquired immunodeficiency syndrome (AIDS)-related PML treated with highly active antiretroviral therapy (HAART).
The clinical course and serial MRI findings in five patients with AIDS-related PML who were treated with HAART are described.
Although all five patients were serologically naive to the therapy and alive at the end of the observation period, the lesions showed rapid extension on MRI for up to 3 months after the start of the therapy, and clinical symptoms progressed rapidly for a month after the start of the therapy. Newer margins in spreading lesions showed a diffuse pale hyperintensity and/or many discrete hyperintense dots on T2-weighted images
Early PML lesions may show a characteristic appearance on T2-weighted images. We should be aware of the progression of AIDS-related PML even under serologically effective HAART.
本研究旨在阐明进行性多灶性白质脑病（PML）的早期磁共振成像（MRI）表现，并评估接受高效抗逆转录病毒治疗（HAART）的获得性免疫缺陷综合征（AIDS）相关PML患者的临床病程与系列MRI表现之间的关系。
描述了5例接受HAART治疗的AIDS相关PML患者的临床病程及系列MRI表现。
尽管所有5例患者在治疗前血清学检测均未接触过该疗法且在观察期末仍存活，但治疗开始后长达3个月内，病变在MRI上迅速扩展，治疗开始后1个月内临床症状迅速进展。扩散性病变的新边缘在T2加权图像上表现为弥漫性淡高信号和/或许多离散的高信号点。
早期PML病变在T2加权图像上可能呈现特征性表现。即使在血清学上有效的HAART治疗下，我们也应警惕AIDS相关PML的进展。
