What is the role of imaging in the workup of cytomegalovirus (CMV) encephalitis in HIV?

Updated: Jul 25, 2017
  • Author: Gulshan Uppal, MD; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Answer

Answer

Computed tomography (CT) and magnetic resonance imaging (MRI) can aid in the diagnosis and can exclude other diagnostic considerations (eg, absence of parenchymal enhancement, evidence of increased intracranial pressure [ICP]). Head CT and MRI findings include encephalitis involving the cerebral hemispheres and brainstem, ventriculitis, meningitis, and infarcts. Hydrocephalus and cerebral atrophy have been reported. Periventricular calcification, a marker of congenital CMV infection, is not seen.

Mass lesions due to CMV have been reported but are rare. T2-weighted MRI may show diffuse white matter hyperintensity similar to that seen in HIV encephalopathy and other HIV-associated central nervous system (CNS) disorders. Gadolinium contrast MRI may reveal meningeal and ependymal enhancement, as well as ring enhancing lesions.


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