Progressive multifocal leukoencephalopathy in AIDS: initial and follow-up CT and MRI

Neuroradiology. 1997 Sep;39(9):611-8. doi: 10.1007/s002340050478.


We sought to determine the value of follow-up CT and MRI in patients with acquired immuno-deficiency syndrome (AIDS) and progressive multifocal leukoencephalopathy (PML). We reviewed 50 CT and 19 MRI examinations performed in 21 biopsy- or autopsy-proven cases of PML; 17 patients had follow-up examinations (mean time 5.9 weeks). The radiological examinations were correlated with pathological findings at autopsy. On initial imaging studies, 73 lesions were found. On follow-up, the most striking feature was rapid progression in both size and number of the lesions (from a mean of 3.2 to 6.9 per patient). One third of the patients showed increasing mass effect. A central area suggesting necrosis, of variable size, was found in 12/16 patients. Autopsy revealed macroscopic necrotic changes in the lesions in 11/16 patients.

MeSH terms

  • AIDS Dementia Complex / diagnosis*
  • Adult
  • Biopsy
  • Brain / pathology*
  • Cerebral Cortex / pathology
  • Female
  • Follow-Up Studies
  • Humans
  • Leukoencephalopathy, Progressive Multifocal / diagnosis*
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Necrosis
  • Tomography, X-Ray Computed*