HIV - What can we learn from a MRI or CT scan?

• Ring-enhanced single lesion: abscess, with frequency toxoplasmosis > TB > cryptococcosis. The peripheral staining by the contrast medium shows the oedema zone around the abscess. On this basis a test therapy will often be started without having formal proof of toxoplasmosis. If there is no improvement within two weeks or if deterioration occurs, a stereotactic brain biopsy should be performed. In addition to these three etiologies, there can be other causes of an intracranial mass: herpes, Histoplasma, Nocardia, Candida, Kaposi, metastasis. In 10% of cases no specific cause is found.
  
• Non-ring enhanced lesion: probably lymphoma > PML. In case of PML there is no mass effect.
  
• Bilateral diffuse lesions: immune reconstitution syndrome if in the correct context.
  
• Multiple ring lesions: toxoplasmosis >> tuberculosis.
  
• HIV atrophy: broadened sulci and enlarged ventricles (DD internal hydrocephalus: flattened sulci and enlarged ventricles).
  

Category: Brain , Conditions and Diseases , Health , HIV , Immune reconstitution inflammatory syndrome , Infectious disease , Medical Subject Notes , Progressive multifocal leukoencephalopathy , Tuberculosis