C Carra-Dalliere1, N Menjot de Champfleur2, J Deverdun2, X Ayrignac3, E Nerrant3, A Makinson4, M L Casanova4, P Labauge3. 1. Department of Neurology, Montpellier University Hospital, Gui-de-Chauliac Hospital, 34295 Montpellier, France. Electronic address: clarisse.carra@gmail.com. 2. Department of Neuroradiology, Montpellier University Hospital, Gui-de-Chauliac Hospital, 34295 Montpellier, France; Institut d'imagerie fonctionnelle humaine (I2FH), Montpellier University Hospital, 34295 Montpellier, France. 3. Department of Neurology, Montpellier University Hospital, Gui-de-Chauliac Hospital, 34295 Montpellier, France. 4. Department of Infectious Diseases, Montpellier University Hospital, Saint-Éloi Hospital, 34295 Montpellier, France.
Abstract
BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is an opportunistic demyelinating encephalopathy related to JC virus. Its characteristics on conventional brain MRI are well known and are important for the diagnosis. OBJECTIVE: To analyze SWI hypointensities recently described in U-fibers and cortex adjacent to the white matter lesions of PML. METHODS: Prospective study including four patients with an history of definite diagnosis of PML. Clinical data were collected retrospectively. Brain MRI exams were done on a 3T magnet, including FLAIR, T2 GRE sequences and SWI. RESULTS: Four males were included (mean age: 47 years, mean PML duration: 24.2 months). Immunosuppression was related to AIDS (n=2), natalizumab for multiple sclerosis (n=1), B-cell lymphoma treated by chemotherapeutic agents and rituximab (n=1). All patients had SWI hypointensities in cortex and/or U-fibers adjacent to the white matter lesions. QSM always suggested a paramagnetic effect. CONCLUSION: SWI and T2 GRE hypointensities in cortex and U-fibers adjacent to the white matter lesions seem highly prevalent in PML, irrespective of the delay between PML onset and the MRI. QSM data suggest a paramagnetic effect.
BACKGROUND: Progressive multifocal leukoencephalopathy (PML) is an opportunistic demyelinating encephalopathy related to JC virus. Its characteristics on conventional brain MRI are well known and are important for the diagnosis. OBJECTIVE: To analyze SWI hypointensities recently described in U-fibers and cortex adjacent to the white matter lesions of PML. METHODS: Prospective study including four patients with an history of definite diagnosis of PML. Clinical data were collected retrospectively. Brain MRI exams were done on a 3T magnet, including FLAIR, T2 GRE sequences and SWI. RESULTS: Four males were included (mean age: 47 years, mean PML duration: 24.2 months). Immunosuppression was related to AIDS (n=2), natalizumab for multiple sclerosis (n=1), B-cell lymphoma treated by chemotherapeutic agents and rituximab (n=1). All patients had SWI hypointensities in cortex and/or U-fibers adjacent to the white matter lesions. QSM always suggested a paramagnetic effect. CONCLUSION: SWI and T2 GRE hypointensities in cortex and U-fibers adjacent to the white matter lesions seem highly prevalent in PML, irrespective of the delay between PML onset and the MRI. QSM data suggest a paramagnetic effect.
Authors: Kedar R Mahajan; Moein Amin; Matthew Poturalski; Jonathan Lee; Danielle Herman; Yufan Zheng; Caroline Androjna; Mark Howell; Robert J Fox; Bruce D Trapp; Stephen E Jones; Kunio Nakamura; Daniel Ontaneda Journal: Mult Scler Date: 2021-03-22 Impact factor: 5.855
Authors: Giuseppe Pontillo; Sirio Cocozza; Roberta Lanzillo; Pasquale Borrelli; Anna De Rosa; Vincenzo Brescia Morra; Enrico Tedeschi; Giuseppe Palma Journal: Front Neurol Date: 2017-06-19 Impact factor: 4.003