Nowadays of great importance is not only the issue of early diagnosis of HIV infection, but of early detection and effective treatment of AIDS complications. The annual increase in the incidence of HIV infection amounts to 4%. Unfortunately, a great number of patients ask for hospital care when their disease has the stage of secondary complications. Such situation requires a fast and affordable diagnostics together with verification of the nature of the affection. Purpose. To evaluate the diagnosis effectiveness of the secondary infectious cerebral affection in patients with HIV infection using the method of non-contrast MRI including the usage of the specially developed software. One hundred thirty three patients were recruited for the study, the main group of 108 persons (as old as 36,8±8,3), all referred to the brain MRI with suggestion of neurologic complications of HIV. The control group comprised 25 patients of the same age with focal damage of vascular nature. In everybody the MRI has been carried out using open middle-field scanner (Az-360, by AZ plc company, Moscow) with field induction 0,4 T, supplied with wireless four-channel quadratur coil for head studies, without contrast enhancement, but using in everybody the specially designed protocols for compensation of movement artifacts. All patients were re-examined in 2, 4 and 6 weeks. MRI images both in first admission and in follow-up studies were reported first qualitatively by type of contour of pathologic focus, by presence of multiple pattern of focal damage, by ultrastructure of foci, extent of perifocal oedema, interhaemispheric dislocation; also the dimensions of lateral ventriculi, of external subarachnoidal spaces and thickness of cortex in various regions were measured. Focal cerebral damage verified later as toxoplasmosis was revealed in the main group in 80% (86 of 108) of patients. False-negative and false-positive conclusions of MRI studies were not revealed also in prospective follow-up studies. Of these in 69 (80,2%) the pathologic foci were multiple and did localize periventricularly in particular in putamen, nucleus caudatus, equally frequent for both haemispherae, single foci were detected in thalami, concomitant with tendency to extensive cortical dystrophy. The putamen region was involved more frequently as compared to other basal ganglii (р=0,003). No significant differences were revealed between various cortical regions as regard to frequency of detection of pathologic foci. Four weeks period was detected as being the most effective time for the dynamic control in the course of treatment. Conclusion. Middle-field MRI of the brain with compensation of movement artifacts is a proper technique for both the diagnosis and follow-up control of treatment of cerebral toxoplasmosis in patients with HIV infection.

A multimodal diagnostic study of the brain was carried out in 22 patients with arterial hypertension (mean systolic blood pressure 152,8 ± 7,6 mm Hg, mean diastolic blood pressure 94,6 ± 5,2 mm Hg), without cardiovascular events in anamnesis. Magnetic resonance imaging (MRI) imaging and dynamic contrast-enhanced perfusion X-ray computer assisted tomography scan (DynCT) of the brain were performed at admission and after six months of antihypertensive treatment. Based on the MRI and DynCT visual data the extent of periventricular oedema, dimensions of liquor system and regional cerebral blood flow (as ml/min/100 g tissue) were quantified. The quantitative MRI and DynCT indices were analyzed regarding the decrease of blood pressure. Significant decrease of periventricular oedema and improvement in perfusion of basal ganglii area were observed in patients demonstrated decrease in systolic blood pressure for 12-28 mm Hg. The degree of the blood pressure decrease was not associated with the significant MRI and DynCT data improvement. Hencefore, we conclude that the brain MRI and perfusion DynCT data can be employed for evaluation of cerebroprotective effects of antihypertensive therapy.

The study included 15 patients with arterial hypertension and verified periventricular enhancement of Т2-weighted MR image in a zone around the horns of lateral brain ventricles. All patients as well as control nonhypertensive group underwent MRI study enhanced with injection of paramagnetic contrast agent as 2 ml of 0,5M saline sloution per 10 kg of BW. The enhancement of periventricular T1-weighted image after contrast injection was quantified as ratio of MRI intensities after and before injection. Increase of permeability of blood-brain barrier in zones of periventricular hypostasis was revealed.

Dynamics of hypertensive encephalopathy signs and brain perfusion under influence 6-month therapy by felodipine was estimated. The study included 29 patients having hypertension of the II stage. The treatment with felodipine resulted in decreased arterial pressure and signs of intracranial hypertension and increased blood flow in the area of periventricular edema. It is concluded that felodipine has expressed cerebroprotective efficacy besides its hypertensive action.