Persistent enhancement after treatment for cerebral toxoplasmosis in patients with AIDS: predictive value for subsequent recurrence.

Abstract

PURPOSE:

To determine the predictive imaging (CT and/or MR) features of brain toxoplasmosis recurrences in acquired immunodeficiency syndrome.

METHODS:

The imaging studies of patients with brain toxoplasmosis were retrospectively reviewed. Forty-three patients with significant decrease or disappearance of brain lesions under specific treatment on follow-up imaging examinations were included. MR examinations were performed using T2- and T1-weighted sequences, before and after intravenous administration of gadolinium-DOTA.

RESULTS:

A recurrence occurred in 11 (26%) of 43 cases. Ten (91%) of these 11 patients with recurrence showed focal persistent enhancement after the initial treatment of toxoplasmosis abscess. One of the 11 patients with recurrence showed no persistent enhancement; 3 patients showed persistent enhancement but had no recurrence.

CONCLUSIONS:

Recurrences of brain toxoplasmosis in our series correlated with persistent contrast enhancement. We hypothesize that demonstration of persistent areas of contrast enhancement after treatment for initial toxoplasmosis may be a valuable sign for identifying patients at risk for recurrence.

• Authors: J P Laissy, P Soyer, C Parlier, S Lariven, Z Benmelha, V Servois, E Casalino, E Bouvet, A Sibert, F Vachon
• Journal: AJNR. American journal of neuroradiology (AJNR Am J Neuroradiol) Vol. 15 Issue 9 Pg. 1773-8 (Oct 1994) ISSN: 0195-6108 [Print] United States
• PMID: 7847227 (Publication Type: Journal Article)

Chemical References

• Sulfadiazine
• Pyrimethamine

Topics

• AIDS-Related Opportunistic Infections (diagnosis, drug therapy)
• Adult
• Aged
• Atrophy
• Brain (pathology)
• Brain Abscess (diagnosis, drug therapy)
• Drug Therapy, Combination
• Encephalomalacia (diagnosis)
• Female
• Follow-Up Studies
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Pyrimethamine (therapeutic use)
• Recurrence
• Sulfadiazine (therapeutic use)
• Toxoplasmosis, Cerebral (diagnosis, drug therapy)