Пример: "acute HIV encephalitis is only partial and mild. On the MR images the involved white matter ..... and several *dot-like lesions* in the basal ganglia..."

"A review of the magnetic resonance (MR) images of 365 patients with acquired immunodeficiency syndrome (AIDS) revealed that 112 (31%) had signal abnormalities confined to the **white matter**. Four patterns were observed: (a) diffuse: widespread involvement of a large area; (b) patchy: localized involvement with ill-defined margins; (c) focal: well-defined areas of involvement; and (d) ****punctate: small foci less than 1 cm in diameter****..."

("White Matter Disease in AIDS: Findings at MR Imaging")

(From the Departments of Radiology... and Neurology..., University of California, San Francisco, and San Francisco General Hospital)

http://radiology.rsnajnls.org/cgi/reprint/169/2/445

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Pediatr Neurol. 1999 Mar;20(3):241-3.

Posterior **leukoencephalopathy** syndrome may not be reversible.

Antunes NL, Small TN, George D, Boulad F, Lis E.

Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.

The association of an acute reversible encephalopathy with transient occipital lobe abnormalities on imaging studies is well known. This condition has been called reversible posterior leukoencephalopathy syndrome... A computed tomography scan of the head revealed marked bilateral lucencies mainly involving the **white matter** of the occipital lobes, with a few **foci of punctate hemorrhage**...

http://www.ncbi.nlm.nih.gov/pubmed/10207937?ordinalpos=18&it...

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Neuroradiology. 2003 Jul;45(7):493-7.

MRI in methotrexate-related **leukoencephalopathy**: Disseminated necrotising leukoencephalopathy in comparison with mild leukoencephalopathy.

Oka M, Terae S, Kobayashi R, Sawamura Y, Kudoh K, Tha KK, Yoshida M, Kaneda M, Suzuki Y, Miyasaka K.

Department of Radiology, Hokkaido Graduate University School of Medicine, 060-8638, Sapporo, Japan. [email protected]

We report two fatal cases of methotrexate (MTX)-induced disseminated necrotising leukoencephalopathy (DNL) in which MRI was repeated from the onset. Initial T2-weighted images showed multiple areas of high signal, mainly in deep cerebral white matter, which on follow-up, spread and coalesced to involve the entire white matter. **Small** irregular low-signal **foci** on T2-weighted images were seen within the high-signal lesions...

http://www.ncbi.nlm.nih.gov/pubmed/12761601?ordinalpos=12&it...

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Funct Neurol. 2004 Oct-Dec;19(4):239-42.

Early diagnosis in cerebral autosomal dominant arteriopathy with subcortical infarcts and **leukoencephalopathy** (CADASIL): the role of MRI.

Fattapposta F, Restuccia R, Pirro C, Malandrini A, Locuratolo N, Amabile G, Bianco F.

Department of Neurology and Otolaryngology, University of Rome La Sapienza, Italy. [email protected]

The aim of our work was to evaluate the early presence of white matter changes on magnetic resonance imaging (MRI) in young asymptomatic children of patients with full-blown cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) in whom DNA analysis revealed a Notch3 Cys146Tyr
missense mutation on chromosome 19. Brain MRI was performed in all subjects using axial and coronal spin-echo proton density and T2-weighted images, axial fluid-attenuated inversion recovery (FLAIR) and sagittal and axial T1-weighted images. In asymptomatic subjects with Notch3 gene mutation, MRI showed **small** T2 hyperintense **foci** in periventricular and subcortical white matter...

http://www.ncbi.nlm.nih.gov/pubmed/15776792?ordinalpos=6&ito...

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Acta Neuropathol. 1984;65(2):145-9.

Vascular changes of methotrexate-related disseminated necrotizing
**leukoencephalopathy**

Suzuki K, Takemura T, Okeda R, Hatakeyama S.

We investigated cerebral lesions of methotrexate (MTX)-related disseminated necrotizing leukoencephalopathy (DNL) in two autopsy cases of leukemia by the reconstruction technique of the serial sections and thick sections (700-800 microns) stained with silver impregnation to detect the topographic relation between the vascular changes and parenchymal lesions... There were no remarkable changes in the arteries, except for the moderate endothelial swelling of arteriolar capillaries. The parenchymal lesions were topographically associated with these vascular changes, and the **small necrotic foci**...

http://www.ncbi.nlm.nih.gov/pubmed/6596829?ordinalpos=49&ito...

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Clin Neuropathol. 1985 Jul-Aug;4(4):165-73.

Chronic progressive **leukoencephalopathy** with systemic arteriosclerosis in young adults.

...**small** cystic and softening **foci** in the white matter...

http://www.ncbi.nlm.nih.gov/pubmed/4053457?ordinalpos=46&ito...

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J Acquir Immune Defic Syndr Hum Retrovirol. 1995 May 1;9(1):69-73.

...
Department of Pathology, Medical College of Wisconsin, Milwaukee 53226, USA.

... This disease ranges from **small foci of myelin loss** to extensive areas of demyelination.
...
http://www.ncbi.nlm.nih.gov/pubmed/7712236?ordinalpos=24&ito...

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****Заслуживают, на мой взгляд, внимания и ещё две версии:

1) "microscopic foci" ("micro-foci"), и
2) "miliary foci" (т. е. "просовидные очаги"; в медицине это прилагательное используют нередко).

См. ниже некоторые цитаты на этот счёт...

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J Neurooncol. 1989 Sep;7(3):269-81.

Fatal necrotizing encephalopathy complicating treatment of malignant gliomas with intra-arterial BCNU and irradiation: a pathological study.

Rosenblum MK, Delattre JY, Walker RW, Shapiro WR.

Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, N.Y. 10021.

We describe the neuropathologic findings at autopsy in six patients who developed a progressive encephalopathy complicating the treatment of malignant gliomas with combined intra-arterial 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) and cerebral irradiation. Four brains were free of tumor and one contained a microscopic focus of residual glioma. In only one case was there evidence of tumor progression. A disseminated process characterized by **miliary foci of necrosis**
...
http://www.ncbi.nlm.nih.gov/pubmed/2795121?ordinalpos=5&itoo...

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Neuroradiology. 1998 May;40(5):308-11.

Amyloid angiopathy causing widespread miliary haemorrhages within the brain evident on MRI.
Good CD, Ng VW, Clifton A, Britton JA, Hart Y, Wilkins P.
Department of Neuroradiology, Atkinson Morley's Hospital, London, UK.

The case of a 70-year-old woman with cerebral amyloid angiopathy (CAA) is presented. MRI of the head showed widespread **miliary foci of haemorrhage** within the cerebrum and cerebellum, with some additional linear lesions within the cerebral cortex and patchy lesions in the white matter. This is in contrast to the more usual pattern of intracranial haemorrhage in CAA, i.e., a lobar haematoma.
http://www.ncbi.nlm.nih.gov/pubmed/9638672?ordinalpos=3&itoo...

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Hum Pathol. 1993 Aug;24(8):897-904.
Multifocal necrotizing **leukoencephalopathy** with pontine predilection in immunosuppressed patients: a clinicopathologic review of 16 cases.
...
Department of Pathology, Kaiser-Permanente Medical Center Medicine, Woodland Hills, CA.

Multifocal necrotizing leukoencephalopathy (MNL) is characterized by multiple, usually **microscopic, foci** of necrosis confined primarily to the white matter of...
http://www.ncbi.nlm.nih.gov/pubmed/8375859?ordinalpos=29&ito...

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Toxicology. 2001 Aug 28;165(2-3):97-107.
Prolonged exposure to one percent carbon monoxide causes a **leucoencephalopathy** in un-anaesthetised sheep.
Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand. [email protected]

A total of 15 Levine-prepared adult un-anaesthetised sheep were exposed to 1% carbon monoxide (CO) in air for between 45 and 150 min. This exposure caused a reversible increase in blood carboxyhaemoglobin concentration and heart rate, and a similarly reversible decrease in electroencephalographic frequency and level of consciousness. sheep were either normotensive or slightly hypertensive. Sheep brains were subsequently examined for histopathological changes at either 5 or 14 days post- exposure. No dead neurons or apoptotic cells were seen, but most sheep given a prolonged exposure to CO had some axonal damage and associated gliosis. This damage was concentrated about **necrotic micro-foci** in the **peri-ventricular white matter**. These results suggest that a leucoencephalopathy is a primary consequence of acute and sub-acute CO toxicity.
http://www.ncbi.nlm.nih.gov/pubmed/11522368?ordinalpos=16&it...

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Crit Care Med. 2002 Oct;30(10):2371-5.
**Multifocal necrotizing leukoencephalopathy** in septic shock.
...
OBJECTIVE: Multifocal necrotizing leukoencephalopathy, characterized by multiple **microscopic foci of necrosis** involving the white matter of...
http://www.ncbi.nlm.nih.gov/pubmed/12394971?ordinalpos=14&it...