AIDS脑部病变CT和MRI表现及对比研究  

Experimental comparison study and CT/MRI appearances of patients with AIDS's brain lesion

作　　者：张锦烜[1] 王磊[1] 任月玲[1] 古丽孜拉[1] 张克云[1] 娜迪热[1] 关伟锋[1] 孙伟东[1] 阿娜尔[1] 贺伟[2] 

机构地区：[1]新疆伊犁州友谊医院CT.MR科,835000 [2]新疆医科大学护理学院

出　　处：《中国CT和MRI杂志》2009年第3期22-26,共5页Chinese Journal of CT and MRI

基　　金：新疆伊犁州自然科学研究计划项目(项目编号:yz200501006)

摘　　要：目的总结AIDS患者脑部病变影像特征,对比和探讨CT和MRI的诊断价值及临床意义。方法分析61例AIDS患者的临床和影像资料,并将CT和MRI进行对照研究。结果(1)本组脑萎缩占78.7%;2.病变绝大部分为多发,多见"三多"征象,以顶额叶居多,占43.6%,大部分同时累及皮髓质,平扫大多呈斑片状,占位效应相对较轻,增强后大部分呈环状强化;(3)AIDS患者脑部病变在MRI上可呈现多种颇具特征的征象,如圈套征、搭桥征等;(4)病变大多呈CT低密度,MRI大多T1WI呈低信号,T2WI及Flair呈高信号;弓形体脑病居多;(5)MRI平扫在阳性病例捡出、病变数目显示均多于CT平扫,所能观察到的征象也明显多于CT。结论(1)脑萎缩为AIDS脑部病变最早最多见的影像改变,主要源自HIV感染所致;(2)脑内多发、多部位、多种形态并存的"三多"征象,在AIDS脑部病变中具有较高的诊断价值;(3)对AIDS脑部病变MRI检查明显优于CT,Flair像应作为常规检查序列。Objective To summarize the CT ＆ MRI features of brain lesion in neurologically symptomatic patients with AIDS. To compared and evaluated the diagnostic values and clinical significance ofCT ＆ MRI. Methods The clinical data and CT ＆ MRI images of 61 patients with AIDS were analyzed and compared. Results （l） There were 48 patients having encephalon atrophy in 61cases （78.7%）; （2）The lesions were multifocal mostly （92%） and there were ＂three many＂ features. The presences of lesions were mainly observed in lobusfroutalis and paretalis（43.6%）, the majority in- volving the gray and white matter simultaneously. Speckle schistose appeared on plain CT ＆ MRI. Moreover, the occupying effect was relatively lighter. Major parts assumed cyclic annular change after enhancing; （3）The brain lesions of patients with AIDS may present various characteristic symbols on MRI, like ＂snare＂ or ＂bridging＂ and so on; （4） Lesions assumed low-density mostly on CT. The signal of the lesions on MRI was hypointense on T1WI, however, mostly was hyperintense on T2WI and Flair. The majority of 52 cases showed encephalon toxoplasmosis; （5） The number of brain lesions inspected by plain MRI was more than it by CT. What can be observed on MRI turned out more on CT as well. Conclusion （1）Encephalon atrophy is the earliest observed and most common brain lesions of patients with AIDS on CT ＆ MRI, originating from HIV mainly; （2）It occurs frequently with the multi-spots and various forms of coexistence, which can be called ＂three many ＂ features, having the highly diagnostic values in the brain lesions of patients with AIDS; （3）MRI is superior to CT in inspection of brain lesions of patients with AIDS. Also, flair used to be the routine series.

关 键 词：获得性免疫缺陷综合症 脑 体层摄影术 X线计算机 磁共振成像 对比研究 

分 类 号：R445.2[医药卫生—影像医学与核医学] R814.42[医药卫生—诊断学]