Ernst T, Chang L, Witt M, Aronow H, Cornford M, Walot I.
J Neurovirol. 1998 Jun 3-6; 4: 349.
Harbor-UCLA Medical Center, Torrance, CA.
Cerebral toxoplasmosis and lymphoma, two common neurologic complications in patients with AIDS are difficult to differentiate with clinical and radiologic variables. As a result, many patients with lymphoma are subjected to 2 weeks of empirical treatment with anti-toxoplasma medications. The purpose of this study is to evaluate whether perfusion MRI can differentiate these two diseases. Perfusion MRI was performed prospectively in 13 AIDS patients with focal brain lesions [7 with lymphoma and 6 with toxoplasmosis]. Regional cerebral blood volume was determined by means of dynamic echo planar imaging (EPI) during bolus injection of Gadolinium contrast agent. The additional scan time for perfusion MRI was less than 2 minutes. Regional blood volume was decreased (44% +/- 24% of contralateral) throughout the toxoplasma lesions whereas all active lymphomas displayed areas of increased blood volume (258% +/- 99% of contralateral; p = 0.01). There was no overlap in blood volume values between the two patient groups. Reduced blood volume in toxoplasmosis lesions is most likely caused by a lack of vasculature within the abscess, whereas areas of increased blood volume in lymphomas are probably due to hypervascularity in foci of active tumor growth. In summary, perfusion MRI is a rapid noninvasive tool that has potential to improve the differentiation between cerebral lymphoma and toxoplasmosis in patients with AIDS.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Animals
- Blood Volume
- Brain
- Brain Neoplasms
- Contrast Media
- Echo-Planar Imaging
- Gadolinium
- Gadolinium DTPA
- Humans
- Lymphoma
- Magnetic Resonance Imaging
- Magnetic Resonance Spectroscopy
- Neurosciences
- Perfusion
- Receptors, Mineralocorticoid
- Toxoplasma
- Toxoplasmosis, Cerebral
Other ID:
UI: 102237399
From Meeting Abstracts