AIDS合并弓形虫脑炎患者MRI影像特征的临床观察  

Clinical observation on MRI manifestations of AIDS patients complicated with Toxoplasma gondii encephalopathy

作　　者：郭家辰 任美吉 李莉[1] 李宏军[1] Guo Jiachen;Ren Meiji;Li Li;Li Hongjun(Department of Radiology,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院放射科,100069

出　　处：《北京医学》2023年第12期1049-1052,1057,共5页Beijing Medical Journal

基　　金：国家自然科学基金(61936013)。

摘　　要：目的 探讨AIDS合并弓形虫脑炎患者的MRI表现及影像特征。方法 选取2016—2022年首都医科大学附属北京佑安医院AIDS合并弓形虫脑炎患者11例。根据经抗弓形虫治疗后神经系统症状是否好转分为预后良好组(9例)和预后不良组(2例),比较两组患者的MRI影像特征。结果 11例AIDS合并弓形虫脑炎患者中男10例,女1例,年龄25~64岁,平均(44.3±14.7)岁。弓形虫脑炎病灶为多发、广泛分布,典型病灶为结节状,周围常伴有水肿,病灶表现为T1加权像(T1 weighted image, T1WI)低信号,T2加权像(T2 weighted image, T2WI)高信号,增强呈环状强化和(或)“偏心性靶征”。预后不良组T1WI病灶内出现高信号比例及病灶直径>2 cm比例高于预后良好组,差异均有统计学意义(P<0.05)。结论 AIDS合并弓形虫脑炎患者MRI影像表现具有一定特点,病灶直径>2 cm和病灶内出血征象可提示预后不良。Objective To explore the MRI features of AIDS patients complicated with Toxoplasma gondii encephalopathy.Methods A total of 11 patients of AIDS patients with Toxoplasma gondii encephalopathy in Beijing Youan Hospital affiliated to Capital Medical University from 2016 to 2022 were selected,and were divided into good prognosis group(nine cases)and poor prognosis group(two cases)according to the changes of central nervous system symptoms after anti Toxoplasma gondii treatment,and the MRI features of the two groups were compared.Results Among 11 patients with AIDS complicated with Toxoplasma encephalitis,there were 10 males and one female,aged from 25 to 64 years,with an average of(44.3±14.7)years.The focus of Toxoplasma gondii encephalopathy was multiple and widely distributed,and the typical focus was nodular,often accompanied by edema.The focus showed low signal on T1 weighted image(T1WI)and high signal on T2 weighted image(T2WI).The enhancement showed circular enhancement and(or)"eccentric target".The proportion of high signal intensity and lesion diameter>2 cm in T1WI with poor prognosis group was higher than that in good prognosis group,and the differences were statistically significant(P<0.05).Conclusions The MRI manifestations of AIDS complicated with Toxoplasma gondii encephalopathy have certain characteristics,and the diameter of the focus is>2 cm and the signs of bleeding in the focus can indicate poor prognosis.

关 键 词：AIDS 弓形虫脑炎 MRI影像特征 

分 类 号：R512.91[医药卫生—内科学] R531.8[医药卫生—临床医学]