MRI of infections and neoplasms of the spine and spinal cord in 55 patients with AIDS

Our purpose was to describe the range of MRI findings in infectious and neoplastic involvement of the spine and spinal cord in symptomatic patients with the acquired immunodeficiency syndrome (AIDS). MRI studies in 55 patients with AIDS and neurological signs and symptoms thought to be related to th...

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Bibliographic Details
Published in:Neuroradiology 2000-08, Vol.42 (8), p.551-563
Main Authors: THURNHER, M. M, POST, M. J. D, JINKINS, J. R
Format: Article
Language:English
Subjects:
Acquired Immunodeficiency Syndrome - complications
Adult
AIDS-Related Opportunistic Infections - pathology
Biological and medical sciences
Female
Human viral diseases
Humans
Infectious diseases
Magnetic Resonance Imaging
Male
Medical sciences
Middle Aged
Spinal Cord Diseases - pathology
Spinal Cord Neoplasms - complications
Spinal Cord Neoplasms - pathology
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
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Summary:Our purpose was to describe the range of MRI findings in infectious and neoplastic involvement of the spine and spinal cord in symptomatic patients with the acquired immunodeficiency syndrome (AIDS). MRI studies in 55 patients with AIDS and neurological signs and symptoms thought to be related to the spine or spinal cord were reviewed. We categorized the findings according to the spinal compartment involved. There were 29 patients with extradural, 11 with intradural-extramedullary and 9 with intramedullary disease. In 6 patients more than one compartment was involved simultaneously, and patients presented with multiple lesions in the same compartment. The most common causes of extradural disease were bone lesions (28); an epidural mass was seen in 14 and spondylodiscitis in 4 patients. Cytomegalovirus polyradiculitis was the most common cause of intradural-extramedullary disease (in 10 cases); herpes radiculitis was seen in two, and tuberculous infection in another two. In three cases leptomeningeal contrast enhancement was due to lymphoma. Human immunodeficiency virus (HIV) myelitis was seen in two patients, presumed vacuolar myelopathy in two, toxoplasma myelitis in four, intramedullary lymphoma in one, and herpes myelitis in one. Familiarity with the various potential pathological entities that can affect the spine and spinal cord in the AIDS population and their imaging characteristics is crucial for initiation of further diagnostic tests and appropriate medical or surgical treatment.
ISSN:0028-3940
1432-1920
DOI:10.1007/s002340000344