艾滋病患者脑部常见病变的CT表现

目的 探讨AIDS脑部常见疾病CT特点,提高诊断水平.方法 对25例AIDS患者脑部CT资料进行回顾性分析.结果 急性HIV脑炎6例,CT平扫基底节区、侧脑室周围见片状低密度,增强1例无强化;亚急性HIV脑病5例,表现为不同程度的脑萎缩.弓形体脑病4例,CT示深部脑白质的等密度结节及周围水肿或大片水肿区内见等密度环.巨细胞病毒脑炎3例,CT示双侧枕叶、内囊后肢和丘脑对称性低密度.进行性多灶性脑白质病3例,CT示额、顶、枕叶皮质下多个片状低密度,近邻脑回更清晰,远离脑室.混合感染性脑病4例,包括2种疾病的CT特点.结论 CT检查有益于AIDS常见脑部病变的鉴别诊断.     

艾滋病合并播散性马尔尼菲青霉菌病的腹部CT表现

目的 观察艾滋病(AIDS)合并播散性马尔尼菲青霉菌病(PSM)的腹部CT表现.方法 回顾性分析35例AIDS合并播散性PSM的腹部CT扫描表现.结果35例AIDS合并播散性PSM腹部CT示腹腔淋巴结肿大27例(77.1%);肝脾肿大18例(51.4%);肝脾实质病变共11例(31.4%),其中肝内多发低密度结节3例(8.6%),脾内多发低密度结节5例(14.3%),肝密度弥漫减低5例(14.3%)及肝脏强化不均匀5例(14.3%);肠壁增厚3例(8.6%);腹水4例(11.4%);胰腺炎1例(2.9%).结论AIDS合并播散性PSM腹部常多脏器受累,腹腔淋巴结肿大、肝脾肿大、肝脾实质病变是其最常见的腹部CT影像表现.     

艾滋病并发脑感染的CT表现

目的探讨艾滋病病毒中枢神经系统感染的影像学特征及诊断。方法对14例确认艾滋病合并中枢神经系统感染患者的CT影像进行分析。结果艾滋病脑炎10例,均无占位效应。脑萎缩现象5例,其中2例单独存在,3例与病灶并存。平扫病变呈片状低密度,以脑白质受累为主;6例累及双侧多个脑叶,分布不对称;2例位于左脑。其中2例增强无强化。巨细胞病毒感染1例,平扫两枕叶见片状低密度,对称分布。弓形体脑病3例,2例见等密度灶并周围水肿,1例显示脑脓肿征象。结论根据CT影像特征,结合流行病学询问,可提出本病疑似诊断。     

艾滋病相关腹部淋巴瘤的临床及CT表现特征

【摘要】目的：总结分析艾滋病相关腹部淋巴瘤的CT表现特征,对比非艾滋病与艾滋病相关淋巴瘤（ARL）的临床及影像学表现异同。方法：回顾性分析28例经手术病理证实的艾滋病相关淋巴瘤患者的临床及CT表现。结果：28例艾滋病相关淋巴瘤中霍奇金病1例,非霍奇金淋巴瘤27例,受累脏器包括肝脏10例、脾脏9例、胰腺6例、肾脏5例、胃肠道8例、结内病变23例。病变器官解剖结构留存,病灶多数密度均匀,呈轻中度均匀强化,小部分病变中央出现坏死,呈环形轻中度强化。淋巴结以腹主动脉周围、腹腔干周围、肠系膜、肠系膜根部最为好发。ARL病灶侵袭性高,累及范围广,对放化疗反应性较差。结论：ARL的CT表现具有一定特征性,结合临床表现,有利于提高诊断符合率。     

艾滋病合并腹部结核的CT表现

目的 研究艾滋病(AIDS)合并腹部结核的CT表现.方法 回顾性分析33例经病理、病原学证实及临床诊断艾滋病合并腹部结核的腹部CT扫描表现.结果 33例AIDS合并腹部结核患者腹部CT示腹部淋巴结肿大23例(69.7%,23/33);肝脾肿大10例(30.3%,10/33);脾内多发低密度结节14例(42.4%,14/33),其中脾内弥漫粟粒状低密度结节9例(27.3%,9/33);肝内低密度结节7例(21. 2%,7/33),其中肝脓肿1例(3.0%,1/33);腹膜及大网膜增厚5例(15.2%,5/33),其中伴腹腔积液2例(6.1%,2/33);回盲部肠壁不规则增厚4例(12.1%,4/33);腰椎骨质破坏伴椎旁脓肿及左腰大肌脓肿1例(3.0%,1/33),腰大肌脓肿1例(3.0%,1/33).结论 AIDS合并腹部结核常表现肝脾结核、腹部淋巴结结核、肠结核及腹膜结核等,CT对病灶的检出有重要意义.     

艾滋病合并肺癌的CT表现

【摘要】目的：分析、总结AIDS合并肺癌的临床及CT表现特点,提高对AIDS合并肺癌的认识。方法：回顾性分析经临床病理证实的17例AIDS合并肺癌患者的临床及CT表现。结果：AIDS合并肺癌以中年男性多见,常合并肺部感染。CT多表现为外周分布的类圆形、分叶状软组织肿块,多合并纵隔和/或肺门淋巴结肿大。伴有肺部感染者与不伴肺部感染者相比,在肿块分布、外形、密度、邻近肺野及胸膜改变、肿大淋巴结方面差异均无统计学意义（Fisher确切概率法,P>0.05）,但肿块较大、伴有胸水在两者间差异有统计学意义（t检验,P=0.02;Fisher确切概率法,P=0.04）。结论：中年男性AIDS患者伴有肺部机会性感染时,若肿块较大、出现胸水且对症处理后效果不明显时,应考虑到肺癌的可能。     

艾滋病合并肺部真菌感染的CT表现

目的:探讨艾滋病合并肺部真菌感染的CT表现特点。方法:回顾性分析14例艾滋病合并真菌感染患者的胸部CT扫描资料。结果:病变主要位于肺外周、胸膜下或沿支气管分布,双肺散在或弥漫分布6例,局限性病灶8例,其中病灶位于肺下叶和/或中叶(舌叶)7例,右上叶4例,左上叶(除舌叶)1例。病灶呈大小不等结节影6例,单发类圆形肿块影2例,以空洞为主的病灶4例,小片状或大片状融合实变影5例,网结状影2例;纵隔及肺门淋巴结肿大3例,少量胸腔积液1例,高分辨力CT扫描显示树芽征3例。结论:艾滋病合并肺部真菌感染CT表现各异,主要表现为肺叶外周单发或散在分布大小不等结节伴或不伴空洞影、小片状或大片状实变影、网结状影及"树芽征",艾滋病患者CT扫描一旦出现此类征象,应高度警惕伴有真菌感染的可能。     

艾滋病患者肺部疾病的影像学诊断

目的分析艾滋病患者肺部疾病的影像学特征,并评价其在鉴别诊断中的意义。方法 12例经临床证实的艾滋病患者肺部疾病,包括卡氏肺囊虫感染7例,卡波氏肉瘤2例,肺结核2例,以及真菌感染1例,均经胸部X线检查,8例又经胸部CT扫描,对所有患者的影像表现进行了回顾性分析。结果 7例卡氏肺囊虫感染表现为双肺弥漫性病变,呈网状合并斑片状、结节状及磨玻璃样影,2例卡波氏肉瘤表现为直径小于等于1cm的结节影,沿支气管血管分布,伴小叶间隔增厚或淋巴结肿大,2例肺结核表现为血行播散型和浸润型各1例,1例真菌感染表现为肺内结节伴空洞形成及空洞内结节与气体半月征。结论胸部X线与CT检查在艾滋病患者各种肺部疾病的鉴别诊断中起重要作用。     

HIV阳性/AIDS病人的肺部机遇性感染的影像学表现

肺部感染是HIV阳性病人和AIDS病人主要机遇性感染，其病原体主要包括细菌、病毒、真菌、原虫等，常有多种病原混合感染，影像学表现复杂，包括毛玻璃影、实变、结节以及肺门或纵隔淋巴结增大，常缺乏特异性，X线胸片正常并不能除外肺部感染的可能性，CT能发现更多更细微的病变，有助于提高诊断准确率。     

艾滋病合并肺部恶性肿瘤的CT表现

【摘要】目的：探讨艾滋病相关肺部恶性肿瘤的CT表现特征。方法：回顾性分析8例艾滋病合并肺部恶性肿瘤患者的CT表现。结果：4例卡波西肉瘤中3例表现为支气管血管束增粗、小叶间隔增厚,多个沿支气管血管束分布的结节、纵隔、腋窝或肺门淋巴结肿大,双侧胸腔积液,1例主要表现为结节;1例淋巴瘤为单发肿块,病灶内可见坏死及空气支气管征,增强扫描呈轻度不均匀强化;3例肺癌均为明显强化的孤立肿块,腺癌为形态不规则的外周型肿块伴肺内转移,鳞癌和小细胞癌为中央型肿块,前者可见阻塞性肺炎、肺不张及病灶侧肺门淋巴结肿大,后者纵隔及病灶侧肺门淋巴结显著肿大,3例病灶侧均可见胸腔积液。结论：艾滋病合并肺内恶性肿瘤的CT表现具有一定特征性,CT检查对其诊断及鉴别诊断具有重要价值。     

Progressive multifocal leukoencephalopathy in AIDS: initial and follow-up CT and MRI

We sought to determine the value of follow-up CT and MRI in patients with acquired immunodeficiency syndrome (AIDS) and progressive multifocal leukoencephalopathy (PML). We reviewed 50 CT and 19 MRI examinations performed in 21 biopsy- or autopsy-proven cases of PML; 17 patients had follow-up examinations (mean time 5.9 weeks). The radiological examinations were correlated with pathological findings at autopsy. On initial imaging studies, 73 lesions were found. On follow-up, the most striking feature was rapid progression in both size and number of the lesions (from a mean of 3.2 to 6.9 per patient). One third of the patients showed increasing mass effect. A central area suggesting necrosis, of variable size, was found in 12/16 patients. Autopsy revealed macroscopic necrotic changes in the lesions in 11/16 patients. Received: 30 May 1996 Accepted: 14 October 1996     

HIV感染者和AIDS患者并发肺结核的CT表现

目的 探讨HIV感染者和艾滋病患者(HIV/AIDS)并发肺结核的CT表现特征.方法回顾性分析48例HIV/AIDS并发肺结核的CT表现.结果 HIV/AIDS患者肺结核的CT表现为:继发型肺结核19例(39.6%),病变形态以斑片状阴影为主,10例可见融合成大片的实变影;血行播散型肺结核17例(35.4%),其中急性粟粒型肺结核7例,表现为大小、分布均匀的粟粒影,而亚急性血行播散型10例,表现为大小、分布不均匀的粟粒、小结节影;多种征象混合表现10例(20.8%),表现为双肺斑片状渗出病灶与弥漫分布的粟粒、小结节灶相混杂.纵隔淋巴结肿大36例(75.0%),胸腔积液13例(27.1%),心包积液10例(20.8%).结论 HIV/AIDS并发肺结核的CT特征为局灶性肺实质病变较少而弥漫性的病变较多.     

艾滋病相关性颅内新型隐球菌感染的MRI诊断

目的:探讨艾滋病合并颅内新型隐球菌感染的MRI表现.方法:回顾分析经病原学证实的9例艾滋病合并颅内新型隐球菌感染的MRI表现.结果:根据颅内新型隐球菌感染MRI表现及病理机制,将艾滋病合并颅内新型隐球菌感染分为4型:Ⅰ脑膜脑炎型(1例),Ⅱ类梗死型(1例),Ⅲ梗死型(6例),Ⅳ肉芽肿型(1例).结论:艾滋病合并颅内新型...     

CNS involvement in AIDS: spectrum of CT and MR findings

The brain may be affected by a variety of abnormalities in association with human immunodeficiency virus (HIV) infection. Knowledge of their existence and characteristic imaging features are important to radiologists for detection, diagnosis, and initiation of an appropriate treatment. Although there is a considerable overlap in the imaging characteristics of different entities, some findings are found to be very suggestive of a particular disease. The CT and MR imaging techniques are commonly used in the diagnosis of neurological disorders in acquired immunodeficiency syndrome (AIDS) patients, to verify treatment response and to guide brain biopsy. This review attempts to describe CT and MR features of infectious and malignant brain disorders in HIV-seropositive patients. Received 1 July 1996; Revision received 21 October 1996; Accepted: 28 November 1996     

纳米孔三代测序在HIV/AIDS合并肺部感染者快速病原学鉴定的应用价值探讨

目的通过对人类免疫缺陷病毒/获得性免疫缺陷综合征（Human Immunodeficiency Virus/Acquired Immunedeficiency Syndrome,HIV/AIDS）合并肺部感染者纤维支气管镜肺泡灌洗液样本进行研究,探讨纳米孔三代测序（Oxford Nanopore Technologies）对样本快速病原学鉴定的准确性。方法本研究共纳入2例HIV/AIDS合并肺部感染并留取肺泡灌洗液样本的患者,使用纳米孔三代测序对样本DNA进行测序,提取不同时间点的测序数据进行生物信息学分析,并与常规病原体检查和二代测序（Illumina）等方法进行比较,评价纳米孔三代测序对样本快速病原学鉴定的准确性。结果本研究纳入的患者A常规病原学检查和二代测序的结果均提示铜绿假单胞菌感染,纳米孔三代测序仅需1 h测序数据即发现样本中存在铜绿假单胞菌的基因序列;患者B常规病原学检查和二代测序的结果均提示肺炎克雷伯杆菌,屎肠球菌和结核分枝杆菌混合感染,纳米孔三代测序1 h的测序结果即可检测出肺炎克雷伯杆菌和屎肠球菌的基因序列,6 h的测序结果即可检测出结核分枝杆菌的序列。因此,加上对肺泡灌洗液样本处理、DNA文库构建和生物信息学分析的耗时（合计约2 h）,仅需8 h左右即可检测出上述样本的致病微生物。结论纳米孔三代宏基因组测序可对HIV/AIDS合并肺部感染者进行快速病原微生物鉴定,其准确性与常规病原学检查和Illumina二代测序的结果一致。     

Malignant lymphoma of the cranial vault in an HIV-positive patient: imaging findings

We describe the CT and MR imaging findings in an HIV-positive patient with malignant non-Hodgkin's lymphoma of the cranial vault, a rare site for lymphoma involvement. Autopsy revealed lymphomatous bone lesions, lymphoma in the epidural space, and a large necrotic lymphoma in the soft tissue of the skull.     

Cryptococcus meningoencephalitis in AIDS: parenchymal and meningeal forms

CT and MRI in one case of Cryptococcus neoformans infection showed contrast-enhancing parenchymal lesions resembling granulomata or abscesses. After an initial phase without contrast enhancement, the full extent of the lesions was visible within 2 weeks of presentation. The enhancing masses were assumed to represent intracerebral cryptococcomas. Despite evidence of massive meningeal infection on cerebrospinal fluid (CSF) examination, no radiological signs of meningitis, invasion of the Virchow-Robin spaces or ventriculitis could be demonstrated. With antimycotic treatment the contrast enhancement disappeared and cystic, partly calcified lesions remained. Recurrence of meningeal infection without radiological correlates was apparent in this stage. In a second case of proven cryptococcus meningitis, dilation of Virchow-Robin spaces or cysts in the adjacent parenchyma were the main abnormalities on MRI. Enhancing masses were not detected. These cases may represent two different reactions of the immunocompromised hosts to infection with C. neoformans: widening of the perivascular spaces as a correlate of the more typical meningeal infection and enhancing parenchymal lesions as a sign of further invasion from the CSF spaces. Enhancement of cryptococcomas, indicating an inflammatory response in the surrounding brain, is not typical in patients with impairment of immune function. Received: 11 March 1998 Accepted: 19 June 1998     

艾滋病合并马尔尼菲青霉菌肺炎的CT表现

目的：探讨艾滋病合并马尔尼菲青霉菌肺炎的CT群聚空洞表现特征。方法：临床确诊的艾滋病合并马尔尼菲青霉菌肺部感染患者6例均行螺旋CT胸部扫描,其中1例前后3次复查CT对比。6例马尔尼菲青霉菌肺部感染均经病理及病原学确诊。结果：6例病变均呈多个大小不等的空洞成群聚集,呈近似蜂窝样改变,洞壁厚薄不均,边缘清楚。空洞之间可有炎症渗出而致分界不清。两肺部位分布无特征性。纵隔淋巴结明显增大。其中1例动态观察显示空洞闭合及出现多发新空洞,并合并卡氏肺孢子菌病感染。结论：艾滋病合并肺部感染马尔尼菲青霉菌CT表现为双肺多发群聚空洞具有一定特征性。     

Accuracy of high-resolution CT in distinguishing between Pneumocystis carinii pneumonia and non- Pneumocystis carinii pneumonia in AIDS patients

The aim of this study was to assess the value of high-resolution CT in distinguishing between Pneumocystis carinii and non-Pneumocystis carinii pneumonia (PCP) in patients HIV-positive and high risk to have PCP. We performed a prospective study in 30 patients with <200 CD4 lymphocytes, clinical symptoms of pulmonary disease and chest X-ray non-conclusive for pulmonary infection. Evaluated CT findings included ground-glass opacities, reticulation, tree-in-bud appearance, consolidation, cystic lesions, bronchiectasis and lymphadenopathies. The diagnosis of "examination suggestive of PCP" was applied to cases showing a diffuse or predominant ground-glass pattern in the upper fields, associated or not with reticulations and small cystic lesions. The sensitivity, specificity, positive predictive value and negative predictive value of high-resolution computed tomography (HRCT) for the diagnosis of PCP was 100, 83.3, 90.5 and 100%, respectively. Pneumocystis carinii pneumonia was not demonstrated in any of the cases classified as "examination not suggestive of PCP". Significant small airway disease was not observed in any of the PCP cases. We conclude that HRCT is a reliable method for differentiating PCP from other infectious processes in HIV-positive patients and a good method to rule our PCP. Its inclusion in the diagnostic algorithm of lung infections is justified in these patients. Electronic Publication     

CT/MRI of musculoskeletal complications of AIDS

While uncommon, many musculoskeletal disorders may be seen in association with the acquired immune deficiency syndrome (AIDS). Infections such as osteomyelitis, bacterial myositis and septic arthritis, neoplasms such as non-Hodgkin lymphoma and Kaposi sarcoma, and myopathies and polymyositis have been reported in this patient population. Computed tomography and magnetic resonance imaging frequently detect unanticipated musculoskeletal disease in a patient with AIDS, and may further help to distinguish infections from neoplastic disorders.