Diffusion-Tensor MR Imaging of the Brain in Human Immunodeficiency Virus-Positive Patients

• Published in: American Journal of Neuroradiology Vol. 26; no. 9; pp. 2275 - 2281
• Main Authors: Thurnher, Majda M, Castillo, Mauricio, Stadler, Alfred, Rieger, Armin, Schmid, Brigitte, Sundgren, Pia C
• Format: Journal Article
• Language: English
• Published: Oak Brook, IL Am Soc Neuroradiology 01-10-2005; American Society of Neuroradiology
• Subjects: Adolescent; Adult; Anisotropy; Biological and medical sciences; Brain; Brain - pathology; Corpus Callosum - pathology; Diffusion Magnetic Resonance Imaging; Ear and associated structures. Auditory pathways and centers. Hearing. Vocal organ. Phonation. Sound production. Echolocation; Female; Fundamental and applied biological sciences. Psychology; Hippocampus - pathology; HIV Seropositivity - pathology; HIV Seropositivity - virology; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Nervous system; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Vertebrates: nervous system and sense organs; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Virus; Human; Nervous system diseases; Diffusion tensor; Radiodiagnosis; Central nervous system; Retroviridae; Diffusion imaging; Human immunodeficiency virus; Lentivirus; Nuclear magnetic resonance imaging; Encephalon
• ISSN: 0195-6108; 1936-959X; 1432-1920

There is early evidence that diffusion-tensor imaging (DTI) is useful in demonstrating subtle white matter alterations in different diseases of brain. We hypothesize that DTI in several brain regions in human immunodeficiency virus-positive (HIV+) patients is useful in the early detection of HIV-related brain injury.
MR imaging and DTI were performed in 60 HIV+ patients and in 30 controls. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC; mm/s(2)) maps were generated and coregistered on T2-weighted images. Regions of interest were placed in the splenium and genu of the callosum, the frontal white matter, and the hippocampus. HIV+ patients were divided into those whose CD4 count were <250 cells/mm(3) or >250 cells/mm(3). According to plasma viral loads, patients were divided into those whose viral loads were <50 copies/mL, 50-100,000 copies/mL, or >100,000 copies/mL.
Statistically significant decrease of FA was found in the genu of the corpus callosum in HIV+ patients compared with controls. FA was reduced in the frontal white matter and hippocampi in HIV+ patients compared with controls. Differences, however, were not statistically significant. No statistically significant differences were found between the HIV+ groups for FA of the splenium or between these groups and the controls. ADC values were significantly increased in the genu of HIV+ patients when compared with controls and were also increased in other locations, but without statistical significance.
As used in this study, DTI was not helpful in identifying patients with early HIV infection.