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Progressive Multifocal Leukoencephalopathy and Human Immunodeficiency Virus–associated White Matter Lesions in AIDS: Magnetization Transfer MR Imaging

¹ Departments of Radiology (T.E., I.W.)
² Neurology (T.E., L.C., M.L.Y.)
³ Medicine (M.W.), Harbor-UCLA Medical Center, 1124 W Carson St, N-11, Torrance, CA 90502
⁴ Departments of Neurology and Medicine, University of Southern California Medical School, Los Angeles (H.A.)
⁵ Department of Neurology, Westwood VA Medical Center, Los Angeles, Calif (E.S.).

View larger version (16K): [in a new window]   Figure 1a. Graphs depict dependence of (a) average and (b) minimum magnetization transfer ratio (MTR) values on lesion size and lesion type. There is no overlap in magnetization transfer ratios between HIV-WML () and PML lesions () (P < .0001 for both variables). In the PML group, one lesion with an area of 11.6 cm2 is not shown.

View larger version (16K): [in a new window]   Figure 1b. Graphs depict dependence of (a) average and (b) minimum magnetization transfer ratio (MTR) values on lesion size and lesion type. There is no overlap in magnetization transfer ratios between HIV-WML () and PML lesions () (P < .0001 for both variables). In the PML group, one lesion with an area of 11.6 cm2 is not shown.

View larger version (61K): [in a new window]   Figure 2. Magnetization transfer ratio maps (left) and corresponding FLAIR images (right) of two HIV-WML (top and middle) and PML lesions (bottom). Despite similar appearances on the FLAIR images, the magnetization transfer ratios of the lesions (arrows) are markedly different. The HIV-WML show only moderate, and relatively homogeneous, reductions in magnetization transfer ratio, whereas the PML lesions exhibit areas of very low magnetization transfer ratio. This difference in the magnetization transfer ratio appearance is probably due to the fact that PML is a demyelinating disease, whereas myelin is relatively intact in HIV-WML. The same magnetization transfer ratio color scale is used for both lesions; bright yellow corresponds to the highest magnetization transfer ratio value of 52%.