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KMID : 1103720100630050403
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Journal of the Korean Society of Radiology
2010 Volume.63 No. 5 p.403 ~ p.407
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Progressive Multifocal Leucoencephalopathy Isolated to Posterior Fossa in a Patient with AIDS: DWI and 1H-MRS Features
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Park Byung-Sa
Yu In-Kyu
Lee Byung-Hee
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Abstract
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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.
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KEYWORD
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Leukoencephalopathy, Progressive Multifocal, Acquired Immunedeficiency Syndrome, Cerebellum, Magnetic Resonance Imaging, Protons MR Spectroscopy (1H-MRS)
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