Magnetic Resonance Evaluation of Cerebral Toxoplasmosis in Patients with the Acquired Immunodeficiency Syndrome

Purpose: To evaluate and delineate the characteristics of cerebral toxoplasmosis lesions using a combination of magnetic resonance (MR) spectroscopy, diffusion, and perfusion studies. Material and Methods: A total of 8 patients with 23 lesions were evaluated on a 1.5-T MR system. Diffusion-weighted...

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Bibliographic Details
Published in:Acta radiologica (1987) 2004-04, Vol.45 (2), p.212-221
Main Authors: Batra, A., Tripathi, R. P., Gorthi, S. P.
Format: Article
Language:English
Subjects:
Adult
AIDS-Related Opportunistic Infections - diagnosis
Biological and medical sciences
Diagnosis, Differential
Human protozoal diseases
Humans
Infectious diseases
Investigative techniques, diagnostic techniques (general aspects)
Magnetic Resonance Imaging - methods
Male
Medical sciences
Middle Aged
Parasitic diseases
Protozoal diseases
Toxoplasmosis
Toxoplasmosis, Cerebral - diagnosis
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Summary:Purpose: To evaluate and delineate the characteristics of cerebral toxoplasmosis lesions using a combination of magnetic resonance (MR) spectroscopy, diffusion, and perfusion studies. Material and Methods: A total of 8 patients with 23 lesions were evaluated on a 1.5-T MR system. Diffusion-weighted imaging (DWI) was performed with three 'b' values of 50, 500, and 1000 s mm2, and the apparent diffusion coefficient maps were calculated. The diffusion-weighted appearances and the T2-weighted MR appearances of the lesions were compared. MR spectroscopy was performed using the point-resolved single-voxel technique with two TE values of 135 ms and 270 ms. Perfusion studies were carried out using the dynamic contrast-enhanced technique, and the relative cerebral blood volume maps were qualitatively and quantitatively analyzed. Results: DWI revealed the majority of the lesions as having increased diffusion within their necrotic centers, with the ADC ranging from 0.5 to 3.01 (mean±SD: 1.49±0.7). All the lesions revealed a predominant lipid peak on MR spectroscopy and were extremely hypovascular on perfusion MR studies. Conclusion: MR diffusion, spectroscopy, and perfusion studies help in characterizing toxoplasmosis lesions and, in most cases, can be used in combination to help establish the diagnosis of toxoplasmosis.
ISSN:0284-1851
1600-0455
DOI:10.1080/02841850410003969