[Neuroradiological Diagnosis of Progressive Multifocal Leukoencephalopathy (PML): Pathology of Extending/expanding Demyelinating Lesions Detected by MRI]

Yukiko Shishido-Hara, Masafumi Kanoto
Brain and Nerve, Shinkei Kenkyū No Shinpo 2020, 72 (9): 973-986
Although progressive multifocal leukoencephalopathy (PML) is known as a fatal disease, some recent cases have shown favorable prognosis with early diagnosis. Therefore, detection of early PML lesions using magnetic resonance imaging (MRI) is important. PML lesions are divided into 4 groups based on distinct developing patterns: A)cerebral lesion, B)central lesion including deep gray matter, C)infratentorial lesion of the brain stem and cerebellum, and D)punctate lesions in the deep white matter. These lesions develop in 3 steps: 1)initiation of a small demyelinating lesion, 2)extension/expansion, and 3)fusion. It is likely that the viruses first reach the brain via the bloodstream and form small demyelinating foci (initiation). Second, the demyelinating foci spread along nerve fibers or expand at the sites (extension/expansion). Finally, the foci fuse with one another to form larger demyelinating lesions (fusion). Understanding the spreading patterns of the virus could help early MRI diagnosis of PML, which is important for favorable prognosis. (Received May 7, 2020; Accepted May 11, 2020; Published September 1, 2020).

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"