To present the imaging spectrum of CNS pathologies that occur in AIDS patients.
To delineate the mechanisms responsible for the CNS complications.
CNS involvement in HIV/AIDSpatients is a result of a wide range of processes and depends on different factors such as antiretroviral therapy and patient’s degree of immunosuppression.
Since the administration of HAART therapy in Western countries there has been a decline in the incidence of opportunistic infections and increase in cognitive dysfunction and peripheral neuropathies.
It is also important to note that AIDS patients with CD4 counts less than 200 cells/L are more vulnerable.
Four mechanisms result in CNS manifestations in HIV/AIDS :
Findings and procedure details
CT findings: Multiple areas of low attenuation in the basal ganglia,
thalamus and corticomedullary junction.
May be hyperdense if hemorrhagic.
After administration of IV contrast material these areas demonstrate ring or nodular enhancement (patients with decimated immune systems may not show enhancement).
calcifications may be evident.
MRI findings: On T2-weighted sequences,
lesions appear hypo- to isointense with surrounding high signal intensity vasogenic edema.
On postcontrast MRI there is evidence of multiple nodular lesions or ring enhancing lesions some with an...
In conclusion the role of the radiologists is pivotal,
because recognizing these conditions as well as the impact of HAART treatment can assist in further management of these patients.
Dr Vasiliki Mellou
“Evangelismos” General Hospital of Athens - Athens/GR
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