MRI features of AIDS-related progressive multifocal leukoencephalopathy

Neurologic complications are seen, frequently in the HIV-infected population. Almost 90% of AIDS patients demonstrate CNS abnormalities at autopsy. PML is an oportunistic, subacute, demyelinating viral infection of the central nervous system. Several studies have reported incidenses of PML in patients with HTV ranging from % 1 to % 3.8. In this study, we tried to evaluate the MR characteristics of PML in patients with AIDS. This study suggests that demyelinating areas with scalloping appearance and extension of the lesions across the corpus callosum should considered the diagnosis of PML in patients with AIDS. Although the presence of mass effect and contrast enhancement are unusual fin dings in PML, if present shouldn't exclude the diagnosis. The specificity of non-invasive diagnosis of PML is high, especially when MRI is combined with a positive PCR of JCV- DNA in CSF. Because of potential inability to treat this infection, brain biopsy should be avoided in AIDS patients with MRI findings suggestive of PML and PCR positive results for JCV-DNA in CSF.