Figure 3 MRI findings in opportunistic infections of the CNS

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Figure 3 MRI findings in opportunistic infections of the CNS Figure 3 | MRI findings in opportunistic infections of the CNS. Each MRI series includes a representative image from the following sequences, from left to right: post-gadolinium fluid-attenuated inversion recovery (FLAIR), post-gadolinium T1, and pre-gadolinium T1 sequences. a | Toxoplasma encephalitis. MRI sequences show numerous foci of FLAIR hyperintensity and gadolinium enhancement. Lesions are present in the basal ganglia as well as on the pial surfaces and in the CSF along the subarachnoid space. Oedema and mass effect are minimal. b | Tuberculous meningitis. The post-gadolinium FLAIR image shows extensive oedema throughout much of the left temporal lobe. The post-gadolinium T1 image shows a dense, multinodular exudate with extensive enhancement throughout the brainstem that extends into the cerebral hemispheres. c | Progressive multifocal leukoencephalopathy. A large left parietal lesion seen on the FLAIR sequence extends into the centrum semiovale and corpus callosum. Minimal enhancement limited to the leading edge of the lesion is visible on post-gadolinium sequences. No oedema or mass effect is present. d | Cytomegalovirus encephalitis and retinitis. A linear area of high-intensity signal is visible throughout the periventricular margins, and is best seen on the FLAIR sequence. T1 post-gadolinium sequences demonstrate subtle hyperintensity of these areas. Post-gadolinium FLAIR sequence at the level of the orbits shows cytomegalovirus retinitis. e | Cryptococcal meningitis and cerebritis. Post-gadolinium FLAIR images reveal extensive leptomeningeal enhancement, most prominently throughout the left hemisphere. A large left frontal hyperintensity with associated enhancement on T1 post-gadolinium sequences indicates a focus of cerebritis, which can co-occur with the more typical signs of cryptococcal meningitis. Bowen, L. N. et al. (2016) HIV-associated opportunistic CNS infections: pathophysiology, diagnosis and treatment Nat. Rev. Neurol. doi:10.1038/nrneurol.2016.149