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Progressive Multifocal Leucoencephalopathy Isolated to Posterior Fossa in a Patient with AIDS: DWI and 1H-MRS Features  

Park, Byung-Sa (Department of Radiology, Eulji University Hospital)
Yu, In-Kyu (Department of Radiology, Eulji University Hospital)
Lee, Byung-Hee (Department of Radiology, Eulji University Hospital)
Publication Information
Journal of the Korean Society of Radiology / v.63, no.5, 2010 , pp. 403-407 More about this Journal
Abstract
We report a case of progressive multifocal leukoencephalopathy (PML) isolated to the posterior fossa in a 55-year-old male with acquired immune deficiency syndrome (AIDS). Initial MR images revealed a few foci of patchy increased signal intensity (SI) on a T2-weighted image and a diffusion weighted image (DWI) at the pons, right middle cerebellar peduncle, and right cerebellar hemisphere, with no enhancement. After anti-retroviral therapy, follow-up MR images revealed the more prominent extent of previously-seen lesions and newly discovered newly developed focal increased SI on T2-weighted images located left of the inferior cerebellar hemisphere. Proton MR spectroscopy (1H-MRS) showed a slightly increased choline peak (3.2 ppm) and lactate peak (1.35 ppm), as well as a decreased N-acetylaspartate (NAA) peak (2.0 ppm), which suggests active demyelinating disease. DWI and 1H-MRS may support the diagnosis of PML in patients with AIDS.
Keywords
Leukoencephalopathy, Progressive Multifocal; Acquired Immunedeficiency Syndrome; Cerebellum; Magnetic Resonance Imaging; Protons MR Spectroscopy (1H-MRS);
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