获得性免疫缺陷综合征相关消化道病变的影像学表现

目的：初步探讨艾滋病（AIDs）相关消化道病变的影像学表现。方法：回顾性分析11例AIDS相关消化道病变的影像学表现。行胸部平片检查11例，胸部CT扫描4例，腹部CT扫描9例，盆腔CT扫描2例，盆腔MRI检查1例，消化道内窥镜检查9例。结果：11例中消化道穿孔3例（食管穿孔2例，胃穿孔1例）、肠结核2例、巨细胞性肠炎1例、淋巴瘤4例、胃腺癌1例。食管穿孔的主要影像表现为食管一纵隔瘘伴纵隔淋巴结结核及双肺结核；胃穿孔主要表现为胃瘘伴肝左叶及肝胃间隙脓肿；肠结核主要表现为回盲部肠壁增厚；巨细胞性肠炎主要表现为乙状结肠末段及直肠管壁向心性增厚；淋巴瘤主要表现为受累消化道管壁肿块状增厚，肠腔狭窄或扩张，多伴溃疡及病变周围淋巴结增大；胃腺癌主要表现为胃壁增厚、僵硬及明显强化。结论：AIDS相关消化道病变可表现为多种机会性感染和恶性肿瘤，影像学检查对这些病变的诊断具有重要作用。

Imaging findings of gastrointestinal lesions in AIDS

Objective：To investigate the imaging findings of gastrointestinal lesions in AIDS patients. Methods：The imaging findings of 11 AIDS patients with gastrointestinal lesions were retrospectively analyzed. Plain chest film was per- formed in 11 cases,chest CT in 4 cases,abdomen CT in 9 cases,pelvic CT in 2 cases,pelvic MRI in 1 case,and gastrointesti- nal endoscopic examination in 9 cases. Results： Gastrointestinal perforation was found in 3 cases （2 cases esophageal perfora- tion and 1 case gastric perforation） ;intestinal tuberculosis in 2 cases; cytomegalovirus enteritis in 1 case; lymphoma in 4 cases;and gastric adenocarcinoma in 1 case. The radiologic image of esophageal perforation showed mediastino-esophageal fistula with mediastinal lymph nodes tuberculosis and pulmonary tuberculosis;gastric perforation showed gastric fistula with left lobe hepatic abscess and hepatogastric space abscess;intestinal tuberculosis showed thickening of ileocecal wall;cyto- megalovirus colitis showed thickening wall of the lower part of sigmoid colonand rectum; lymphoma showed tumor-like thickening of gastrointestinal wall,luminal stenosis or dilatation,accompanied by ulcer and peripheral lymph node enlarge- ment;gastric adenocarcinoma demonstrated thickening, stiffness and significant enhancement of stomach wall. Conclusion： Gastrointestinal lesions in AIDS patients may present a variety of opportunistic infections and malignancies, and imaging examination plays an important role in diagnosis of these lesions.