Carra-Dalliere C, Menjot de Champfleur N, Deverdun J, Ayrignac X, Nerrant E, Makinson A, Casanova M L, Labauge P
Department of Neurology, Montpellier University Hospital, Gui-de-Chauliac Hospital, 34295 Montpellier, France.
Department of Neuroradiology, Montpellier University Hospital, Gui-de-Chauliac Hospital, 34295 Montpellier, France; Institut d'imagerie fonctionnelle humaine (I2FH), Montpellier University Hospital, 34295 Montpellier, France.
J Neuroradiol. 2016 Feb;43(1):6-10. doi: 10.1016/j.neurad.2015.08.001. Epub 2015 Oct 23.
Progressive multifocal leukoencephalopathy (PML) is an opportunistic demyelinating encephalopathy related to JC virus. Its characteristics on conventional brain MRI are well known and are important for the diagnosis.
To analyze SWI hypointensities recently described in U-fibers and cortex adjacent to the white matter lesions of PML.
Prospective study including four patients with an history of definite diagnosis of PML. Clinical data were collected retrospectively. Brain MRI exams were done on a 3T magnet, including FLAIR, T2 GRE sequences and SWI.
Four males were included (mean age: 47 years, mean PML duration: 24.2 months). Immunosuppression was related to AIDS (n=2), natalizumab for multiple sclerosis (n=1), B-cell lymphoma treated by chemotherapeutic agents and rituximab (n=1). All patients had SWI hypointensities in cortex and/or U-fibers adjacent to the white matter lesions. QSM always suggested a paramagnetic effect.
SWI and T2 GRE hypointensities in cortex and U-fibers adjacent to the white matter lesions seem highly prevalent in PML, irrespective of the delay between PML onset and the MRI. QSM data suggest a paramagnetic effect.
进行性多灶性白质脑病（PML）是一种与JC病毒相关的机会性脱髓鞘性脑病。其在传统脑MRI上的特征已为人熟知，对诊断很重要。
分析最近在PML白质病变附近的U纤维和皮质中描述的磁敏感加权成像（SWI）低信号。
前瞻性研究纳入4例确诊为PML的患者。回顾性收集临床资料。在3T磁体上进行脑MRI检查，包括液体衰减反转恢复序列（FLAIR）、T2梯度回波序列（T2 GRE）和SWI。
纳入4例男性（平均年龄：47岁，平均PML病程：24.2个月）。免疫抑制与艾滋病有关（2例）、与用于治疗多发性硬化的那他珠单抗有关（1例）、与接受化疗药物和利妥昔单抗治疗的B细胞淋巴瘤有关（1例）。所有患者在白质病变附近的皮质和/或U纤维中均有SWI低信号。定量磁敏感图（QSM）总是提示有顺磁效应。
无论PML发病与MRI检查之间的间隔时间如何，PML患者白质病变附近的皮质和U纤维中的SWI及T2 GRE低信号似乎非常普遍。QSM数据提示有顺磁效应。
