Use of quantitative susceptibility mapping (QSM) in progressive multifocal leukoencephalopathy

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Carra-Dallière, C. | Menjot de Champfleur, Nicolas | Deverdun, Jeremy | Ayrignac, Xavier | Nerrant, E. | Makinson, Alain | Casanova, Marie-Laure | Labauge, Pierre

Edité par CCSD ; American Society of Neuroradiology -

International audience. BACKGROUND:Progressive multifocal leukoencephalopathy (PML) is an opportunistic demyelinating encephalopathy related to JC virus. Its characteristics on conventional brain MRI are well known and are important for the diagnosis.OBJECTIVE:To analyze SWI hypointensities recently described in U-fibers and cortex adjacent to the white matter lesions of PML.METHODS:Prospective study including four patients with an history of definite diagnosis of PML. Clinical data were collected retrospectively. Brain MRI exams were done on a 3T magnet, including FLAIR, T2 GRE sequences and SWI.RESULTS:Four males were included (mean age: 47 years, mean PML duration: 24.2 months). Immunosuppression was related to AIDS (n=2), natalizumab for multiple sclerosis (n=1), B-cell lymphoma treated by chemotherapeutic agents and rituximab (n=1). All patients had SWI hypointensities in cortex and/or U-fibers adjacent to the white matter lesions. QSM always suggested a paramagnetic effect.CONCLUSION:SWI and T2 GRE hypointensities in cortex and U-fibers adjacent to the white matter lesions seem highly prevalent in PML, irrespective of the delay between PML onset and the MRI. QSM data suggest a paramagnetic effect.

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