The imaging diagnostic criteria of acquired immunodeficiency syndrome associated with primary central nervous system lymphoma

Acquired immune deficiency syndrome (AIDS) related primary central nervous system lymphoma (PCNSL) has unique imaging characteristics. Based on the cases fro; literature and latest research evidence, we formed an updated imaging diagnostic recommendation. MRI with and without contrast media is the strongly recommended imaging technique for AIDS-related PCNSL. Imaging signs or findings are summarized as follows: three high indexes, increased diffusion weighted imaging (DWI) signal in solid parts of the tumor, high density of CT without contrast media, and basically uniform enhancement; two low indexes, hypo-intensity of apparent diffusion coefficient (ADC) maps, iso-or hypo-intensity of T1WI without contrast media and T2WI. Three common indexes, mostly located in the midline area of the brain, often manifesting as multiple cystic changes. The special MRI enhancement was characterized by “Notch sign” “Sharp Angle sign” “Snow-holding sign” and “Jagged or Spinous shape”. For clinically suspected cases, if the imaging findings meet the above imaging findings, it can be used as the imaging diagnostic criteria for the diagnosis of AIDS-related PCNSL. The diagnostic criteria can provide clinicians with abundant and accurate diagnostic information with clear diagnostic basis, which can effectively improve the early diagnosis of AIDS-related PCNSL. It helps to form the best decision-making scheme and to achieve the purpose of early and precise treatment.