艾滋病继发弓形虫脑炎和结核性脑膜炎的磁共振成像诊断价值  

MRI diagnostic value of toxoplasmic encephalitis and tuberculous meningitis secondary to acquired immune dificiency syndrome

作　　者：侯可可 郭应坤[1] 张娜 江敏 HOU Keke;GUO Yingkun;ZHANG Na;JIANG Min(Department of Radiology,West China Second Hospital,Sichuan University,Chengdu 610041,China;Department of Radiology,Chengdu Public Health Clinical Medical Center,Chengdu 610061,China)

机构地区：[1]四川大学华西第二医院放射科,四川成都610041 [2]成都市公共卫生临床医疗中心放射科,四川成都610061

出　　处：《实用放射学杂志》2020年第12期1902-1905,1921,共5页Journal of Practical Radiology

基　　金：四川省医学科研课题计划项目(S19001)。

摘　　要：目的探讨MRI在艾滋病(AIDS)继发弓形虫脑炎(TE)和结核性脑膜炎(TBM)中的临床鉴别诊断价值.方法回顾性分析经临床确诊的33例AIDS继发TE患者及16例AIDS继发TBM患者的MRI平扫、DWI和增强扫描,观察影像学变化并分析.结果AIDS继发TE和AIDS继发TBM患者MRI病灶数目、分布以及继发脑积水无统计学差异,而在大小、灶周水肿程度、平扫信号、有无扩散受限、是否合并出血、强化形态、强化后边缘是否模糊以及是否合并脑膜炎有统计学差异(P<0.05).结论AIDS继发TE和AIDS继发TBM在颅脑MRI表现上差异较大,前者病灶体积大、灶周水肿较明显,部分合并出血,增强后多呈花环状、偏心状边缘模糊强化,部分病灶可见靶征,不易合并脑膜炎.Objective To explore the clinical differential diagnostic value of MRI in toxoplasmic encephalitis(TE)and tuberculous meningitis(TBM)secondary to acquired immune deficiency syndrome(AIDS).Methods 33 patients with AIDS comorbid with TE and sl6 patients with AIDS comorbid with TBM were retrospectively enrolled.Plain sequence,contrast sequences,DWI sequences were analyzed and compared.Results No significant difference were found in the number,distribution and secondary hydrocephalus on MRI in patients with secondary TE and TBMHowever,there were statstical differences in sie,degree of pervocal edema,plain scan signal,limited diffusion,combined hemorrhage,enhanced morphology,blurred margin after enhancerment,and meningitis between both groups(P<0.05).Conclusion AIDS comorbid with TE and TBM show great difference on craniocerebral MRI,the former has larger volume of lesions,more obvious peri focal edema comparing with the later one;in addition,partial hemorrhage,annular enhancement,and eccentric edge blurred enhancement are also mostly occurred in AIDS comorbid with TE.Some lesions can show target sign and less meningitis happened in AIDS comorbid with TE.

关 键 词：艾滋病 弓形虫脑炎 结核性脑膜炎 磁共振成像 

分 类 号：R512.91[医药卫生—内科学] R521.7[医药卫生—临床医学]