Clival marrow changes in AIDS: findings at MR imaging.

To determine the prevalence and clinical significance of marrow changes in the clivus identified at magnetic resonance (MR) imaging in patients with the acquired immunodeficiency syndrome (AIDS). MR images of the head of 119 patients with AIDS and 119 control subjects were retrospectively reviewed. Marrow signal intensity patterns in the clivus of each patient were evaluated and scored as type 1 (homogeneous high signal intensity on T1-weighted images [normal]), type 2 (heterogeneous low signal intensity on T1-weighted images [abnormal]), or type 3 (homogeneous low signal intensity on T1-weighted images [abnormal]) and correlated with clinical parameters including CD4 counts, evidence of previous systemic disease, and presence of coexistent disease on corresponding MR head images. Abnormal clival signal intensity (type 2 and 3) was observed in 64 (54%) patients with AIDS and nine (7.5%) control subjects (P < .001), correlating with both a marked decrease in CD4 count (P < .001) and the presence of systemic disease (P < .001). Clival marrow signal abnormality is commonly identified in patients with AIDS and may be a marker of advanced disease.