J Korean Soc Radiol.  2011 Sep;65(3):207-211.

Imaging Appearance of Human Immunodeficiency Virus Encephalitis on the Diffusion Weighted Images: A Case Report

• Lim HC
• Yu IK
• Oh KS

Abstract

Imaging finding of human immunodeficiency virus (HIV) encephalitis contain bilateral, symmetric, patchy, or diffuse increased T2WI signal intensities in the basal ganglia, cerebellum, brainstem, and centrum semiovale. In particular, the centrum semiovale is most commonly involved. Most of the HIV encephalitis cases are accompanied by brain atrophy. No previous study has reported symmetric increased signal intensity at the bilateral centrum semiovale without brain atrophy on diffusion weighted images in HIV encephalitis patients. Here, we report a case of this. We suggest that radiologists should consider the possibility of HIV encephalitis if there are symmetric increases in signal intensity at the bilateral centrum semiovale on diffusion weighted images of patients with a history of HIV infection.

MeSH Terms

Atrophy
Basal Ganglia
Brain
Brain Stem
Cerebellum
Diffusion
Diffusion Magnetic Resonance Imaging
Encephalitis
HIV
HIV Infections
Humans

Figure

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  Fig. 1 T2 weighted images. The T2 weighted images of the patient showed diffuse "hazy" increased T2 signal intensity at the bilateral frontoparietal centrum semiovale (arrows) (A), both basal ganglia, mainly in the posterior internal capsules (arrows) (B), and the middle (arrows) and superior cerebellar peduncles (C). There was no significant cerebral white matter volume reduction, ventricular widening, or cortical atrophy. The imaging findings were consistent with HIV encephalitis, except for cerebral white matter atrophy and a previous history of HIV infection. Additionally, there was no evidence of other opportunistic cerebral infections in the patient affecting the cerebral white matter. Note.-HIV = human immunodeficiency virus

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  Fig. 2 Diffusion weighted images. There was increased signal intensity on the diffusion weighted images at the bilateral frontoparietal centrum semiovale (A), and both basal ganglia, mainly in both posterior internal capsules (B); this was consistent with the increased area of T2 signal. Diffusion weighted images suggested active and acute brain parenchymal HIV activity. Note.-HIV = human immunodeficiency virus

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