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Barbell Sign”: A Diagnostic Imaging Finding in Progressive Multifocal Leukoencephalopathy

Bezuidenhout, A. Fourie, MD*; Andronikou, Savvas, MD; Ackermann, Christelle, MD; Du Plessis, Anne-Marie, MD; Basson, Derik, MD; Bhadelia, Rafeeque A., MD*

Journal of Computer Assisted Tomography: July/August 2018 - Volume 42 - Issue 4 - p 527–530
doi: 10.1097/RCT.0000000000000719

The recently proposed diagnostic algorithm for progressive multifocal leukoencephalopathy underscores the importance of imaging and emphasizes the role of the radiologist in the diagnostic workup. We describe a case series of patients with visual symptoms and a typical pattern of brain involvement in definite progressive multifocal leukoencephalopathy, for which we have coined the term barbell sign.

From the *Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA;

Department of Radiology, Bristol Royal Hospital for Children and the University of Bristol, Bristol, United Kingdom; and

Department of Radiology, Tygerberg Hospital, Stellenbosch University, Cape Town, South Africa.

Received for publication November 22, 2017; accepted November 27, 2017.

Correspondence to: Abraham Fourie Bezuidenhout, MD, Department of Radiology, Beth Israel Deaconess Medical Center, WCB90, 330 Brookline Ave, Boston, MA, 02215 (e-mail:

The authors declare no conflict of interest.

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