Lanfermann H, Heindel W, Schröder R, Lackner K
Institut und Poliklinik für Radiologische Diagnostik, Universität zu Köln.
Rofo. 1994 Jul;161(1):38-43.
Radiological findings and course of progressive multifocal leukoencephalopathy in 14 patients (1 woman, 13 men; 13 HIV seropositive, 1 chronic lymphatic leukaemia) were analysed retrospectively and correlated with clinical symptoms. A total of 21 CT and 16 MRI studies were evaluated. CT scans and MR images of 9 patients, which had been obtained in less than two weeks, could be compared to each other. MRI was superior to CT: 6 lesions with a diameter of 1 cm and below were not detected on CT scans, in 5 patients the extent of lesions was underestimated. Cortical involvement, mass effect or signs of atrophy were missing. Only 1 of 67 lesions showed a tiny enhancement after Gd injection. Due to the pattern and spread of lesions, which showed a close correlation to the neurologic symptoms, three different types of PML are suggested: 1. initial precentral demyelinisation with contralateral hemiparesis (n = 8); 2. lesions in temporo-occipital locations with visual disturbances (n = 2); 3. predominantly bilateral lesions of cerebellar white matter with ataxia (n = 4).
对14例进行性多灶性白质脑病患者（1名女性，13名男性；13例HIV血清学阳性，1例慢性淋巴细胞白血病）的影像学表现及病程进行回顾性分析，并与临床症状进行关联。共评估了21次CT检查和16次MRI检查。对9例在不到两周内进行的CT扫描和MR图像进行了相互比较。MRI优于CT：6个直径1厘米及以下的病灶在CT扫描中未被检测到，5例患者的病灶范围被低估。未发现皮质受累、占位效应或萎缩迹象。67个病灶中只有1个在注射钆后有微小强化。由于病灶的形态和分布与神经症状密切相关，提出了三种不同类型的进行性多灶性白质脑病：1. 中央前回起始的脱髓鞘伴对侧偏瘫（n = 8）；2. 颞枕部病灶伴视力障碍（n = 2）；3. 以小脑白质为主的双侧病灶伴共济失调（n = 4）。
