Differentiation of Acquired Immune Deficiency Syndrome Related Primary Central Nervous System Lymphoma from Cerebral toxoplasmosis with Use of Susceptibility-Weighted Imaging and Contrast Enhanced 3D-T1WI. (December 2021)

• Record Type: Journal Article
• Authors: Li, Jingjing; Xue, Ming; Lv, Zhibin; Guan, Chunshuang; Huang, Shunxing; Li, Shuo; Liang, Bo; Zhou, Xingang; Chen, Budong; Xie, Ruming
• Is Part Of: International journal of infectious diseases. Volume 113(2021)
• Page Start: 251
• Page End: 258
• Publication Date: 2021-12
• Subjects: Lymphoma -- AIDS-Related -- Central Nervous System -- Magnetic Resonance Imaging -- Susceptibility-Weighted Imaging -- Cerebral toxoplasmosis; AR-PCNSL AIDS related primary central nervous system lymphoma -- SWI Susceptibility Weighted Imaging -- ILSS degree of intralesion susceptibility signal intensity -- EBV Epstein-Barr virus -- DSC dynamic susceptibility-weighted contrast-enhanced -- LSIR Low signal intensity rim -- CLSI central low-signal intensity -- DWI diffusion weighted image -- ADC apparent diffusion coefficient; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.10.023
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: SWI and CE 3D-T1WI were useful in AR-PCNSL and cerebral toxoplasmosis. AR-PCNSL showed a higher SWI-ILSS and larger 3D-T1WI volume enhancement. AR-PCNSL was more likely to present incomplete, irregular LSIRs and CLSI on SWI. Cerebral toxoplasmosis was more likely to present smooth LSIRs on SWI. Abstract: Background: We aimed to investigate whether susceptibility-weighted imaging (SWI) and contrast-enhanced 3D-T1WI can differentiate Acquired Immune Deficiency Syndrome-Related Primary Central Nervous System Lymphoma (AR-PCNSL) from cerebral toxoplasmosis. Methods: This was a prospective cohort study. 20 AIDS patients were divided into AR-PCNSL group (13 cases) and cerebral toxoplasmosis group (7 cases) based on pathology results. We analyzed the appearance of lesions on SWI and enhanced 3D T1WI and ROC curves in the diagnosis of AR-PCNSL and cerebral toxoplasmosis. Results: Cerebral toxoplasmosis was more likely to show annular enhancement (p = 0.002) and complete smooth ring enhancement (p = 0.002). It was also more likely to present a complete, smooth low signal intensity rim (LSIR) (p = 0.002) and an incomplete, smooth LSIR (p = 0.019) on SWI. AR-PCNSL was more likely to present an incomplete, irregular LSIR (p < 0.001) and irregular central low signal intensity (CLSI) (p<0.001) on SWI. The areas under the ROC curve of the SWI-ILSS grade and enhanced volume on 3D-T1WI were 0.872 and 0.862, respectively. Conclusion: A higher SWI-ILSS grade and larger 3D-T1WI volume enhancement were diagnostic for AR-PCNSL. SWI and CE 3D-T1WI were useful in the differential diagnosis of AR-PCNSL and cerebral toxoplasmosis.