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Abstract

We compared delayed triple-dose gadolinium (Gd) (0.3 mmol/kg) T1-weighted (D3x-T1), triple-dose fluid-attenuated inversion-recovery fast spin-echo (fast-FLAIR) (3x-FF) and routine single-dose Gd (0.1 mmol/kg) T1-weighted (1x-T1) images in the detection of central nervous system (CNS) abnormalities in patients with human immunodeficiency virus (HIV) infection. Thirty-three brain MRI scans performed on 29 patients were reviewed by a panel of three neuroradiologists for lesion conspicuity, comparing D3x-T1 with 1x-T1 and D3x-T1 with 3x-FF For each pair of comparisons, the panel reached a consensus about which technique was superior in terms of the number of lesions revealed or lesion conspicuity. Note was made of cases in which a particular technique was judged to alter the radiologic diagnosis. Compared to 1x-T1, D3x-T1 improved lesion detection in 14/29 patients (48%). In three patients (10%), the improvement changed the radiologic diagnosis. Compared to D3x-T1, lesion detection on 3x-FF improved in 19/29 patients (66%), including 11 patients whose lesions were not visible on D3x-T1. However, 3x-FF was inferior to D3x-T1 in four patients. 3x-T1 and 3x-FF images are complementary in the assessment of CNS pathology in symptomatic HIV-positive patients and are especially helpful in the diagnosis of meningeal and white matter abnormalities.

Keywords

triple-dose gadolinium fast-flair MR HIV positive patients neurological symptoms

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Evaluating Triple-Dose Gadolinium T1 and Enhanced Fast-Flair MR Studies in Neurologically Symptomatic HIV-Positive Patients

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