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Human Immmunodeficiency Virus 1–associated Minor Motor Disorders: Perfusion-weighted MR Imaging and ¹H MR Spectroscopy¹

¹ From the Departments of Diagnostic Radiology (F.W., H.J.W., A.A.) and Neurology (H.J.v.G., G.A.), Heinrich-Heine-University, Moorenstr 5, 40225 Duesseldorf, Germany. Received October 15, 2001; revision requested January 8, 2002; final revision received October 11; accepted October 31. Address correspondence to F.W. (e-mail: wensersk@uni-duesseldorf.de).

View larger version (78K): [in a new window]   Figure 1. Transverse rCBF maps for, A, a patient with incipient HIV-1-related MMD (group 2) and, B, a patient with sustained HIV-1-related MMD (group 3). Circles are regions of interest. Quantitative evaluation revealed a higher mean blood flow volume in the basal ganglia in the group 2 patient (81.3 mL/100 mL/min ± 5.3) compared with that in the group 3 patient (39.6 mL/100 mL/min ± 3.3). PW MR imaging data were acquired by using a gadopentetate dimeglumine-enhanced, single-shot T2*-weighted gradient-echo echo-planar sequence (54-msec echo time, 12 sections, 5-mm section thickness, 128 x 128 matrix, 240-mm field of view) performed in 2-second intervals.

View larger version (18K): [in a new window]   Figure 2a. (a, b) 1H MR spectra for two patients. The substantial decline in myo-inositol (mI) signal intensity in the group 3 patient (a), as compared with the normal spectrum of this metabolite in the group 1 patient (b), is obvious. Cho = choline, Cr/PCr = creatine-phosphocreatine, Glx = glutamine-glutamate, NAA = N-acetylaspartate. (c) Placement of target volumes (squares) on sagittal (left), coronal (middle), and transverse (right) T1-weighted two-dimensional fast low-angle shot MR images (300/6, 6-mm section thickness, 144 x 256 matrix, 230-mm field of view) obtained in the group 3 patient (a).

View larger version (19K): [in a new window]   Figure 2b. (a, b) 1H MR spectra for two patients. The substantial decline in myo-inositol (mI) signal intensity in the group 3 patient (a), as compared with the normal spectrum of this metabolite in the group 1 patient (b), is obvious. Cho = choline, Cr/PCr = creatine-phosphocreatine, Glx = glutamine-glutamate, NAA = N-acetylaspartate. (c) Placement of target volumes (squares) on sagittal (left), coronal (middle), and transverse (right) T1-weighted two-dimensional fast low-angle shot MR images (300/6, 6-mm section thickness, 144 x 256 matrix, 230-mm field of view) obtained in the group 3 patient (a).

View larger version (58K): [in a new window]   Figure 2c. (a, b) 1H MR spectra for two patients. The substantial decline in myo-inositol (mI) signal intensity in the group 3 patient (a), as compared with the normal spectrum of this metabolite in the group 1 patient (b), is obvious. Cho = choline, Cr/PCr = creatine-phosphocreatine, Glx = glutamine-glutamate, NAA = N-acetylaspartate. (c) Placement of target volumes (squares) on sagittal (left), coronal (middle), and transverse (right) T1-weighted two-dimensional fast low-angle shot MR images (300/6, 6-mm section thickness, 144 x 256 matrix, 230-mm field of view) obtained in the group 3 patient (a).