Title: Radiological Abnormalities in HIV Infected Patients with Neurologic Symptoms and Diagnostic Accuracy of CT and MRI Scans of Brain
Authors: Ajith MS, Paul V Puthussery, Mohanan K, Brahmadathan MN, Suny Thomas, Suma Job, Raini KP
DOI: https://dx.doi.org/10.18535/jmscr/v5i4.33
Abstract
Introduction: Prevalence of HIV infection is high in India with neurological complications developing in many patients. CT scan and MRI are helpful in identifying the neurological abnormalities in such patients. This study aims to find prevalence of various neurological abnormalities in HIV infected patients with clinical evidence of neurological involvement in a tertiary care center and to assess the accuracy of CT scan and MRI in their evaluation.
Materials and Methods: This was a cross sectional observational study done in Department of Radiodiagnosis, for one year and six months. HIV positive patients having neurological symptoms referred for CT scan or MRI scan of brain were included. CT scan was taken for 54 patients and MRI for 48 patients. Presumed diagnosis was made from radiological diagnosis, history, clinical and laboratory data, based on which the patients were treated. Patients were then followed up for final diagnosis made from medical records, based on history, neurological examination, further imaging, laboratory data and treatment response. We correlated the radiological diagnosis from CT scan and MRI with the final diagnosis. Sensitivity, specificity, positive predictive value and negative predictive value for CT scan and MRI were calculated.
Results & Conclusion: HIV encephalopathy (n=8), toxoplasmosis (n=6), infarcts and tuberculosis (n=5 each) accounted for most neurological abnormalities. MRI was much more sensitive and specific than CT scan. CT scan could predict final diagnosis in 38 out of 54 cases (70.37% sensitivity) while MRI could predict final diagnosis in 43 out of 48 patients (89.58% sensitivity)
Keywords: HIV; neurological; computed tomography; magnetic resonance imaging.
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