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https://open.uns.ac.rs/handle/123456789/13808
Nаziv: | Susceptibility-weighted MR imaging hypointense rim in progressive multifocal leukoencephalopathy: The end point of neuroinflammation and a potential outcome predictor | Аutоri: | Thurnher M. Jasmina Boban Rieger A. Gelpi E. |
Ključnе rеči: | Leukoencephalopathy;MRI | Dаtum izdаvаnjа: | 1-јун-2019 | Čаsоpis: | American Journal of Neuroradiology | Sažetak: | © 2019 American Society of Neuroradiology. All rights reserved. BACKGROUND AND PURPOSE: Progressive multifocal leukoencephalopathy (PML) represents a life-threatening demyelinating disorder of the brain caused by reactivation of a rare opportunistic infection with JC Polyomavirus. The aims of this study were to describe the incidence of a susceptibility-weighted imaging hypointense rim in patients with multifocal leukoencephalopathy and to explore the histologic correlates and prognostic value of the rim with regard to the clinical outcome. MATERIALS AND METHODS: This retrospective study included 18 patients with a definite diagnosis of progressive multifocal leukoencephalopathy. Ten patients were HIV-positive, 3 patients had natalizumab-associated progressive multifocal leukoencephalopathy, 1 patient had multiple myeloma, 3 patients had a history of lymphoma, and 1 was diagnosed with acute myeloid leukemia. Patients were divided into short-(up to 12 months) and long-term (12 months) survivors. A total of 93 initial and follow-up MR imaging examinations were reviewed. On SWI, the presence and development of a hypointense rim at the periphery of the progressive multifocal leukoencephalopathy lesions were noted. A postmortem histologic examination was performed in 2 patients: A rim formed in one, and in one, there was no rim. RESULTS: A total of 73 progressive multifocal leukoencephalopathy lesions were observed. In 13 (72.2%) patients, a well-defined thin, linear, hypointense rim at the periphery of the lesion toward the cortical side was present, while in 5 (27.8%) patients, it was completely absent. All 11 long-term survivors and 2 short-term survivors presented with a prominent SWI-hypointense rim, while 5/7 short-term survivors did not have this rim. CONCLUSIONS: The thin, uniformly linear, gyriform SWI-hypointense rim in the paralesional U-fibers in patients with definite progressive multifocal leukoencephalopathy might represent an end-point stage of the neuroinflammatory process in long-term survivors. | URI: | https://open.uns.ac.rs/handle/123456789/13808 | ISSN: | 1956108 | DOI: | 10.3174/ajnr.A6072 |
Nаlаzi sе u kоlеkciјаmа: | MDF Publikacije/Publications |
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