MRI signal changes of the bone marrow in HIV-infected patients with lipodystrophy: Correlation with clinical parameters

Ana I. García*, Ana Milinkovic, Xavier Tomás, José Rios, Iñaki Pérez, Sergi Vidal-Sicart, Jaume Pomés, Montserrat Del Amo, Josep Mallolas

*Corresponding author for this work

Research output: Contribution to journalReview articleResearchpeer-review

7 Citations (Scopus)

Abstract

Objective To assess the prevalence, imaging appearance, and clinical significance, of bone marrow MR signal changes in a group of human immunodeficiency virus (HIV)-infected patients with lipodystrophy syndrome. Materials and methods Twenty-eight HIV-infected patients with lipodystrophy syndrome treated with highly active antiretroviral therapy, and 12 HIV-negative controls underwent MRI of the legs.Whole-body MRI, SPECT/CT, and a complete radiographic skeletal survey were obtained in subjects with signal changes in bone marrow. MRI and clinical evaluations were reviewed 6 months after baseline to determine changes after switching from thymidine analogs (TA) to tenofovir-DF (TDF). MRI results correlated with clinical parameters. Results We observed foci of a serous-like pattern (low signal and no enhancement on T1-weighted, high signal on T2-weighted images) in 4 out of 28 patients (14.3%) and an intermediate signal on T1-weighted images in 4 out of 28 patients (14.3%). Serous-like lesions were located in the lower limbs and scattered in the talus, calcaneus, femurs, and humeral bones; they showed slight uptake on SPECT bone scans and were normal on CT and radiographs. Patients with serous-like lesions had significantly lower peripheral and total fat at baseline than other groups (P<0.05). No changes at 6 months were observed on MRI, and the serous-like lesion group showed good peripheral fat recovery after changing drug treatment. Conclusion A serous-like MRI pattern is observed in the peripheral skeletons of HIV-infected patients with lipodystrophy, which correlates with peripheral lipoatrophy, and should not be misdiagnosed asmalignant or infectious diseases. Although the MR lesions did not improve after switching the treatment, there was evidence of lipoatrophy recovery.

Original languageAmerican English
Pages (from-to)1295-1301
Number of pages7
JournalSkeletal Radiology
Volume40
Issue number10
DOIs
Publication statusPublished - Oct 2011

Keywords

  • Antiretroviral therapy
  • HIV
  • Lipodystrophy
  • Lower extremities
  • MRI
  • SPECT

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