CT, MR, and pathology in HIV encephalitis and meningitis

M. Judith Post, L. G. Tate, Robert Quencer, G. T. Hensley, J. R. Berger, William Sheremata, G. Maul

Research output: Contribution to journalArticle

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Abstract

The value and limitations of CT and MR in human immunodeficiency virus (HIV) infection of the brain was determined by a retrospective analysis of the CT scans (22) and MR images (7) in 22 patients with pathologically proved HIV encephalitis (21) or meningitis (1). Our clinical-radiologic-pathologic correlation suggested that, especially in the early stages of the disease, CT and MR were relatively insensitive in detecting the primary changes of HIV encephalitis. The multiple bilateral diffuse microscopic glial nodules with multinucleated giant cells of HIV found at autopsy in both gray and white matter were usually not directly visualized by either CT or MR. Secondary, nonspecific changes, however, were seen. These included cortical atrophy, found in virtually all patients with HIV encephalitis, and HIV-induced foci of demyelination found in the minority of cases. On CT the latter were seen in the white matter as nonenhancing, non-mass-producing areas of low density; on MR they were seen as frequently progressive high-intensity signal abnormalities on T2-weighted images, usually in the periventricular white matter and centrum semiovale. MR was more sensitive in detecting these demyelinative lesions than was CT. The clinical diagnosis of HIV encephalitis usually antedated the radiographic diagnosis. In HIV meningitis, contrast CT was more definitive than MR, showing striking enhancement of the subarachnoid spaces, although MR was more sensitive in detecting the secondary parenchymal changes.

Original languageEnglish
Pages (from-to)373-380
Number of pages8
JournalAmerican Journal of Roentgenology
Volume151
Issue number2
StatePublished - Jan 1 1988

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Encephalitis
Meningitis
HIV
Pathology
Subarachnoid Space
Demyelinating Diseases
Virus Diseases
Giant Cells
Neuroglia
Atrophy
Autopsy
Brain
White Matter

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Judith Post, M., Tate, L. G., Quencer, R., Hensley, G. T., Berger, J. R., Sheremata, W., & Maul, G. (1988). CT, MR, and pathology in HIV encephalitis and meningitis. American Journal of Roentgenology, 151(2), 373-380.

CT, MR, and pathology in HIV encephalitis and meningitis. / Judith Post, M.; Tate, L. G.; Quencer, Robert; Hensley, G. T.; Berger, J. R.; Sheremata, William; Maul, G.

In: American Journal of Roentgenology, Vol. 151, No. 2, 01.01.1988, p. 373-380.

Research output: Contribution to journalArticle

Judith Post, M, Tate, LG, Quencer, R, Hensley, GT, Berger, JR, Sheremata, W & Maul, G 1988, 'CT, MR, and pathology in HIV encephalitis and meningitis', American Journal of Roentgenology, vol. 151, no. 2, pp. 373-380.
Judith Post M, Tate LG, Quencer R, Hensley GT, Berger JR, Sheremata W et al. CT, MR, and pathology in HIV encephalitis and meningitis. American Journal of Roentgenology. 1988 Jan 1;151(2):373-380.
Judith Post, M. ; Tate, L. G. ; Quencer, Robert ; Hensley, G. T. ; Berger, J. R. ; Sheremata, William ; Maul, G. / CT, MR, and pathology in HIV encephalitis and meningitis. In: American Journal of Roentgenology. 1988 ; Vol. 151, No. 2. pp. 373-380.
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