MRI诊断获得性免疫缺陷综合征合并结核性脑膜脑炎的价值  

The value MRI in the diagnosis of acquired immune deficiency syndrome complicated with tuberculous meningoencephalitis

作　　者：梅菊芳 黄贤平 吴棒 郭昌英 唐厚 MEI Jufang;HUANG Xianping;WU Bang;GUO Changying;TANG Hou(Department of Imaging,Ganzhou Fifth People's Hospital,Ganzhou,Jiangxi,341000,China)

机构地区：[1]赣州市第五人民医院影像科,江西赣州341000

出　　处：《当代医学》2024年第25期130-133,共4页Contemporary Medicine

摘　　要：目的分析MRI诊断获得性免疫缺陷综合征(acquired immune deficiency syndrome,AIDS)合并结核性脑膜脑炎(tuberculous meningitis,TBM)的价值。方法选取2019年1月至2021年10月赣州市第五人民医院收治的20例AIDS合并TBM患者作为观察组,另选取同期收治的30例非AIDS的TBM患者作为对照组,两组均行MRI检查,比较两组临床表现及合并症、MRI影像学表现、MRI诊断准确率,分析MRI表现类型及MRI增强扫描表现类型。结果观察组病灶直径≥1 cm占比高于对照组,表观弥散系数、弥散加权成像高信号占比均高于对照组,差异有统计学意义(P<0.05)。观察组诊断准确率为95.00%,稍高于对照组的90.00%,但两组比较差异无统计学意义。MRI影像表现:观察组脑池闭塞6例,脑膜增厚8例;经MRI增强扫描后,其中10例患者出现脑膜呈环状强化且伴有脑积水,且较为严重脑积水4例,出现脑梗死1例,结核瘤1例。对照组脑池闭塞7例,脑膜增厚5例,经MRI增强扫描后,其中10例患者脑膜呈环状强化且伴有脑积水,且较为严重脑积水5例,出现脑梗死3例。结论MRI检查能有效提高AIDS合并TBM患者的诊断准确率,具有临床推广应用价值。Objective To analyze the value of MRI in the diagnosis of acquired immune deficiency syndrome(AIDS)combined with tuberculous meningitis(TBM).Methods 20 patients with AIDS combined with TBM admitted to Ganzhou Fifth People's Hospital from January 2019 to October 2021 were selected as the observation group,and 30 non-AIDS patients with TBM admitted during the same period were selected as the control group.The clinical manifestations and comorbidities,MRI imaging manifestations,MRI diagnostic accuracy were compared between the two groups,and MRI manifestations and MRI enhanced scanning manifestations were analyzed between the two groups.Results The proportion of lesions with diameter of≥1 cm in the observation group was higher than that in the control group,and the proportion of ADC and DWI hyperintensity were higher than those in the control group,the differences were statistically significant(P<0.05).The diagnostic accuracy in the observation group was 95.00%,slightly higher than that in the control group 90.00%,but the difference was not statistically significant.MRI findings:6 cases of cisterna occlusion and 8 cases of meningeal thickening in the observation group;After MRI enhancement scan,10 of the patients showed circular enhancement of meninges accompanied by hydrocephalus,4 cases were more serious hydrocephalus,1 case had cerebral infarction,and 1 case had tuberculoma.In the control group,there were 7 cases of cisterna occlusion and 5 cases of meningeal thickening.After MRI enhancement scan,10 of them showed circular enhancement of meninges accompanied by hydrocephalus,5 cases were more serious hydrocephalus,and 3 cases had cerebral infarction.Conclusion MRI imaging technique can effectively improve the diagnostic accuracy of AIDS patients with TBM,it has clinical application value.

关 键 词：获得性免疫缺陷综合征 结核性脑膜脑炎 影像学 

分 类 号：R512.1[医药卫生—内科学] R445.2[医药卫生—临床医学]