艾滋病合并脑内机会性感染患者的CT影像学表现研究  

Study on CT imaging features of patients with AIDS combined with opportunistic intracerebral infections

作　　者：李峰[1] 胡碧波[1] 刘蛟[1] 宓吉峰[2] 

机构地区：[1]宁波市第二医院放射科,浙江宁波315000 [2]宁波市第二医院检验科,浙江宁波315000

出　　处：《中华医院感染学杂志》2015年第4期868-870,共3页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅基金资助项目(2013KYB2520)

摘　　要：目的分析艾滋病合并脑内机会性感染患者多层螺旋CT影像学表现特点,对多层螺旋CT在艾滋病合并脑内机会性感染患者诊断的临床价值进行研究,为及早治疗提供依据。方法对2010年1月-2012年12月收治的36例艾滋病合并脑内机会性感染患者的多层螺旋CT影像特征及临床病理诊断资料进行回顾性总结,数据采用SPSS 19.0软件进行统计分析。结果 36例艾滋病合并脑内机会性感染不同病变患者,CT影像学表现有较大差异,结核性脑膜炎和弓形虫脑病患者低密度病灶表现,分布率分别为66.7%和57.1%,而HIV脑炎和隐球酵母菌性脑炎患者低密度病灶表现较少,分布率分别为40.0%和28.6%,除人类免疫缺陷病毒(HIV)脑炎患者外,其他病变组患者均有占位效应,其中弓形虫脑病组患者85.7%有占位效应;艾滋病合并脑内机会性感染患者脑内病灶多为两侧大脑,并有部分患者累及小脑;隐球酵母菌性脑膜炎患者的CT阳性率最高71.4%,弓形虫脑病患者CT阳性率最低42.8%,差异有统计学意义(P<0.05)。结论多层螺旋CT在艾滋病合并脑内机会性感染的诊断方面具有很高的应用价值,但不同感染类型有较大差异,应加以认真分辨,加强治疗。OBJECTIVE To analyze multi-slice spiral CT imaging characteristics of patients with AIDS combined with opportunistic intracerebral infections and the clinical value of multi-slice spiral CT on diagnosis of such patients so as to provide reference for early treatment.METHODS The multi-slice spiral CT imaging features and clinical data of 36 cases of AIDS combined with opportunistic intracerebral admitted and treated during Jan.2010 to Dec.2012 in our hospital were retrospectively summarized.Data were analyzed with the software SPSS 19.0.RESULTS CT imaging features varied among the 36 patients with different lesions.The patients with tuberculous meningitis and toxoplasma encephalopathy had low density lesions and the lesion distribution rate was 66.7% and57.1% respectively.The patients with HIV encephalitis and Cryptococcus encephalitis had fewer manifestations of low density lesions with the lesion distribution rate of 40.0% and 28.6%.Except for patients human immunodeficiency virus（HIV）encephalitis,all patients had mass effect which appeared in 85.7% of toxoplasma encephalopathy patients.The brain lesions of patients were on both sides of the brain,and involved cerebellum in some patients.The positive rate of CT imaging was the highest in patients with Cryptococcus meningitis,up to71.4%,and the lowest in patients with toxoplasma encephalopathy,being 42.8%,with statistical significance（P〈0.05）.CONCLUSIONThe multi-slice spiral CT has very high application value for diagnosis of AIDS combined with opportunistic intracerebral infection.As there are many differences in different infection types,infections should be carefully distinguished to strengthen treatment.

关 键 词：多层螺旋CT 艾滋病 诊断 脑内机会性感染 临床价值 

分 类 号：R512.91[医药卫生—内科学]