AIDS和非AIDS相关性中枢神经系统新型隐球菌病影像学比较  

Imaging Comparison of Central Nervous System Cryptococcosis Associated with AIDS and Non-AIDS Patients

作　　者：周津如 陈秀杰 李咏梅[2] 董志辉 周旭峰 ZHOU Jin-ru;CHEN Xiu-jie;LI Yong-mei;DONG Zhi-hui;ZHOU Xu-feng(Department of Radiology,Luoyang Central Hospital Affiliated to Zhengzhou University,Luoyang 471000,China;Department of Radiology,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]郑州大学附属洛阳中心医院影像科,河南洛阳471000 [2]重庆医科大学附属第一医院放射科,重庆400010

出　　处：《河南医学研究》2020年第20期3665-3669,共5页Henan Medical Research

摘　　要：目的比较获得性免疫缺陷综合征(AIDS)和非AIDS相关性中枢神经系统新型隐球菌病的临床和影像学特征。方法选取重庆医科大学附属第一医院(2012年1月至2015年8月)及郑州大学附属洛阳中心医院(2017年1月至2019年9月)收治的27例中枢神经系统新型隐球菌感染患者,根据是否感染人类免疫缺陷病毒(HIV),将其分为AIDS组(17例)和非AIDS组(10例),分析两组中枢神经系统隐球菌病临床和影像学的差异。所有患者均经脑脊液培养或墨汁染色证实为隐球菌感染,并进行磁共振成像(MRI)扫描。结果AIDS组和非AIDS组男女比例分别为15∶2和3∶7,两组差异有统计学意义(P<0.05)。AIDS组和非AIDS组年龄、临床症状、实验室检查、转归差异无统计学意义(均P>0.05)。MRI主要表现为血管周围间隙(VRS)增宽、脑膜炎、脑膜脑炎、隐球菌肉芽肿、胶样假囊,有部分患者合并有脑积水。VRS增宽:AIDS组10例,非AIDS组5例。脑膜炎:AIDS组3例,非AIDS组6例。脑膜脑炎:AIDS组3例,非AIDS组4例。胶样假囊:AIDS组5例,非AIDS组1例。隐球菌肉芽肿:该征象发生率较低,AIDS组和非AIDS组各1例。脑积水:AIDS组4例,非AIDS组5例。两组脑膜炎发生率比较,差异有统计学意义(P<0.05),两组VRS增宽、脑膜脑炎、胶样假囊、隐球菌肉芽肿、脑积水发生率比较,差异无统计学意义(均P>0.05)。结论中枢神经系统隐球菌病MRI表现包括VRS增宽、脑膜炎、脑膜脑炎、胶样假囊、隐球菌肉芽肿,部分伴有脑积水改变。AIDS组主要表现为VRS增宽,非AIDS组主要表现为脑膜炎。Objective To compare the clinical and imaging features of central nervous system cryptococcosis in acquired immune deficiency syndrome(AIDS)and non-AIDS patients.Methods A total of 27 patients with central system cryptococcosis treated in the First Affiliated Hospital of Chongqing Medical University(from January 2012 to August 2015)and Luoyang Central Hospital Affiliated to Zhengzhou University(from January 2017 to September 2019)were divided into AIDS group(17 cases)and non-AIDS group(10 cases)according to whether they were infected with human immunodeficiency virus(HIV).The clinical and imaging differences of central nervous system cryptococcosis between the two groups were retrospectively analyzed.All patients were confirmed by cerebrospinal fluid culture or ink staining,and then were scanned by magnetic resonance imaging(MRI).Results The male-to-female ratio of two groups was 15∶2(AIDS group)and 3∶7(non-AIDS group),there was statistical difference between the two groups(P<0.05).However,there was no statistical difference in age,clinical symptoms,laboratory examination and outcome between AIDS group and non-AIDS group(all P>0.05).The main manifestations of MRI were widening of virchow-robin space(VRS),meningitis,meningoencephalitis,cryptococcal granuloma,colloid pseudocysts,and some of which were accompanied by hydrocephalus.Widening of VRS:10 cases in AIDS group and 5 cases in non-AIDS group.Meningitis:3 cases in AIDS group and 6 cases in non-AIDS group.Meningoencephalitis:3 cases in AIDS group and 4 cases in non-AIDS group.Cryptococcal granuloma:the incidence was low,each group had 1 case.Colloid pseudocyst:5 cases in AIDS group and 1 case in non-AIDS group.Hydrocephalus:4 cases in AIDS group and 5 cases in non-AIDS group.The incidence of meningitis in the two groups was statistically different(P<0.05),but there was no statistical difference in other imaging signs(all P>0.05).Conclusion The typical imaging of central nervous system cryptococcosis includes widening of VRS,meningitis,meningoencephalitis,co

关 键 词：获得性免疫缺陷综合征 新型隐球菌 磁共振成像 人类免疫缺陷病毒 

分 类 号：R519.4[医药卫生—内科学]