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Mike Sathekge Ingeborg Goethals Alex Maes Christophe van de Wiele 《European journal of nuclear medicine and molecular imaging》2009,36(7):1176-1184
This paper reviews currently available PET studies performed either to improve our understanding of the pathogenesis of HIV-1
infection or to assess the value of PET imaging in the clinical decision making of patients infected with HIV-1 presenting
with AIDS-related opportunistic infections and malignancies. FDG PET has shown that HIV-1 infection progresses by distinct
anatomical steps, with involvement of the upper torso preceding involvement of the lower part of the torso, and that the degree
of FDG uptake relates to viral load. The former finding suggests that lymphoid tissues are engaged in a predictable sequence
and that diffusible mediators of activation might be important targets for vaccine or therapeutic intervention strategies.
In lipodystrophic HIV-infected patients, limited available data support the hypothesis that stavudine-related lipodystrophy
is associated with increased glucose uptake by adipose tissue as a result of the metabolic stress of adipose tissue in response
to highly active antiretroviral treatment (HAART). Finally, in early AIDS-related dementia complex (ADC), striatal hypermetabolism
is observed, whereas progressive ADC is characterized by a decrease in subcortical and cortical metabolism. In the clinical
setting, PET has been shown to allow the differentiation of AIDS-related opportunistic infections and malignancies, and to
allow monitoring of side effects of HAART. However, in patients suffering from HIV infection and presenting with extracerebral
lymphoma or other human malignancies, knowledge of viraemia is essential when interpreting FDG PET imaging. 相似文献
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Radiographs of symptomatic joints were retrospectively evaluated in 24 patients with inflammatory arthritis and human immunodeficiency virus (HIV) infection. Clinically, 20 patients had a seronegative arthritis including Reiter syndrome (54%), psoriatic arthritis (17%), and undifferentiated forms of spondyloarthropathy (13%). These patients were indistinguishable radiographically from patients with typical seronegative disorders except for the predominance of lower-extremity abnormalities. Four patients (17%) had a rheumatoidlike arthritis defined as acute symmetric polyarthritis (ASP). With the exception of extensive proliferative periostitis, ASP simulated classic rheumatoid arthritis. HIV-associated arthritis was manifest during various stages of HIV infection. It preceded acquired immunodeficiency syndrome in 64% of patients with stage IV HIV infection. Awareness of the coexistence of HIV infection in patients with the above-mentioned arthritides is important, since immunosuppressive therapy, commonly used in the treatment of arthritis, can have detrimental effects in patients with HIV infection. 相似文献
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The clinical, laboratory, and radiographic findings in seven patients with acquired immunodeficiency syndrome (AIDS) and cryptococcal pulmonary infections were reviewed. The infection was most commonly seen on radiographs as lymphadenopathy, interstitial infiltrates, or both. Interstitial infiltrates were commonly nodular. Large nodules or alveolar infiltrates, the most common findings at presentation in both immunocompetent patients and immunocompromised patients without AIDS, were not present in our series. Isolated pleural effusion was seen as the only radiographic finding in one case. Meningitis was present in six of seven cases and was neurologically silent in five of six cases. Cryptococcal pneumonia in AIDS patients should prompt a search for neurologically silent cryptococcal meningitis. 相似文献
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Biphosphonates are now being used experimentally in children to increase bone mass, but their long-term effects remain an issue of concern. We report two cases of biphosphonate-induced radiographic changes in children with rheumatic diseases. Our experience supports the view that clinical improvement and radiographic findings after biphosphonate therapy are related to increased bone mineral density, without effects on the inflammatory process itself. Biphosphonates seem to act in rheumatic diseases by reducing bone turnover instead of improving disease activity. 相似文献
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SARS康复期患者半年血清抗体、肺功能和影像学资料分析 总被引:3,自引:0,他引:3
目的了解SARS康复者SARS冠状病毒特异性IgG抗体、肺功能和肺部影像学的变化。方法293例北京地区SARS患者康复后半年内定期进行SARS冠状病毒特异性IgG抗体、肺功能和胸部影像学检查,合并有肺弥散功能异常的康复者定期进行肺功能和胸部影像学复查,动态观察肺功能的恢复情况。部分合并有骨关节疼痛的患者进行股骨头磁共振检查。结果293例中有233例SARS冠状病毒特异性IgG抗体阳性(79.5%),且半年内抗体水平有逐渐下降趋势。特异性IgG抗体阳性的康复者中56例合并有肺部影像学异常,57例(24.5%)合并有弥散功能(D1CO)异常,其中40例半年内进行了3次以上肺功能检查,发现其肺功能和肺部影像学变化均有不同程度的改善。60例进行股骨头磁共振检查的康复者中有15例发现有股骨头缺血性坏死改变(25%)。结论临床诊断为SARS的患者中可能有部分为误诊病例,SARS康复者合并的肺纤维化改变在一定时期内可明显吸收和好转,部分康复者合并有股骨头缺血性坏死改变。 相似文献
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Background
There are several methods of evaluating adenoidal size pre-operatively. Plain nasopharyngeal radiography is a common investigative modality: it has been advocated, and also condemned.Aim
This study was intended to assess nasopharyngeal airway obstruction by the adenoids using plain X-rays; and also to find correlation if any, with the symptomatology.Methods
This is a retrospective study carried out between January and December 2008. The case notes and plain X-rays of the nasopharynx of 34 paediatric patients with clinical features of obstructive adenoids were analyzed.Results
A total of 34 children were studied, 22 (64.7%) were males and 12 (35.3%) were females. Their ages ranged between 7 months and 10 years: mean age was 3.55 years, standard deviation 2.723. Majority (67.6%) of the children were in the age group 0-4 years. The lowest symptomatology assessment score was 0 and the highest was 3. Children 4 years and below had the highest symptomatology scores. The minimum adenoidal-nasopharyngeal ratio was 0.35 and the maximum was 0.94. There was no significant difference in the mean adenoidal-nasopharyngeal ratio of males and females (t = 0.407; p = 0.692). Many (75.0%) of the children with moderate to severe nasopharyngeal airway obstruction by the adenoids were in the age bracket 0-4 years. The lowest adenoidal-nasopharyngeal ratio score was 0 and the highest was 3. Children 4 years and below had the highest adenoidal-nasopharyngeal ratio scores. There was a very weak nonsignificant correlation between the symptomatology assessment score and the radiological assessment score (r = 0.168; p = 0.375).Conclusion
The adenoidal-nasopharyngeal ratio is reliable in assessing the nasopharyngeal airway in children with obstructive adenoids. 相似文献12.
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Aspergillus infection of the respiratory tract after lung transplantation: chest radiographic and CT findings 总被引:4,自引:0,他引:4
The objective of our study was to assess radiographic and CT findings in lung transplant patients with evidence of Aspergillus colonization or infection of the airways and correlate the findings with clinical, laboratory, bronchoalveolar lavage, biopsy
and autopsy findings. The records of 189 patients who had undergone lung transplantation were retrospectively reviewed for
evidence of Aspergillus colonization or infection of the airways. Aspergillus was demonstrated by culture or microscopy of sputum or bronchoalveolar lavage fluid or histologically from lung biopsies
or postmortem studies in 44 patients (23 %). Notes and radiographs were available for analysis in 30 patients. In 12 of the
30 patients (40 %) chest radiographs remained normal. In 11 of 18 patients with abnormal radiographs pulmonary abnormalities
were attributed to invasive pulmonary aspergillosis (IPA) in the absence of other causes for pulmonary abnormalities (8 patients)
or because of histological demonstration of IPA (3 patients). In these 11 patients initial radiographic abnormalities were
focal areas of patchy consolidation (8 patients), ill-defined pulmonary nodules (2 patients) or a combination of both (1 patient).
In some of the lesions cavitation was demonstrated subsequently. At CT a “halo” of decreased density was demonstrated in some
of the nodules and lesion morphology and location were shown more precisely. Demonstration of Aspergillus from the respiratory tract after lung transplantation does not necessarily reflect IPA but may represent colonization of
the airways or semi-invasive aspergillosis. The findings in patients with IPA did not differ from those described in the literature
in other immunocompromised patients, suggesting that surgical disruption of lymphatic drainage and nervous supply or effects
of preservation and transport of the transplant lung do not affect the radiographic appearances.
Received 24 March 1997; Revision received 27 June 1997; Accepted 20 August 1997 相似文献
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Hand radiographs from 160 patients with scleroderma were reviewed. The presence of calcinosis distal to the metacarpophalangeal joints was significantly associated with the female sex, disease duration over 10 years, digital ulceration, telangiectasia, tuft erosion and the presence of anticentromere antibodies. The presence of calcinosis proximal to the metacarpophalangeal joints was significantly associated with tuft erosions and erosions involving all joints. The lack of distal calcinosis was significantly associated with anti Scl 70 and antinucleolar antibodies. The prevalence of other radiological manifestations of scleroderma such as osteoarthritis, erosions and dorsal tuft modelling was documented. Specific radiological findings correlate with certain clinical and serological characteristics in scleroderma. 相似文献
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Shih SL Lee YJ Lin SP Sheu CY Blickman JG 《Acta radiologica (Stockholm, Sweden : 1987)》2002,43(1):40-43
Objective: To assess the CT findings of the airway in children with mucopolysaccharidoses (MPS).Material and Methods: The study included 13 patients (9 boys, 4 girls; age range 2-17 years; mean age 9.2 years) with MPS: 6 with Hunter syndrome, 3 with Maroteaux-Lamy syndrome, 2 with Sanfilippo syndrome, 1 with Hurler/Scheie syndrome and 1 with Morquio syndrome. CT of the airways was done in the axial section with 3-mm collimation from the oropharynx at the level of C3 to the base of the lung. The shape of the vocal cords and trachea at the level of T1 was evaluated. The tracheal surface area (TSA) at the level of T1 was measured both in patients and in age-matched subjects.Results: CT showed an abnormality of the vocal cords in 7 of the 13 patients. Six patients had an abnormal shape and 7 had an inhomogenous density. The abnormalities included elliptical (5 of 6) and star-shaped (1 of 6) cords. Eight of 13 tracheas were also abnormal, either U-shaped (6 of 8) or worm-shaped (2 of 8). The TSA was significantly smaller in patients (79.6±28.9 mm2) than in control subjects (138.1±50.1 mm2). The TSA of those ≤9 years was 61.4±15.2 mm2 as compared with 99.9±23.5 mm2 for the control group. The TSA of patients ≥11 years was 107.1±25.3 mm2 as compared with 187.6±32.0 mm2 for the control group.Conclusion: Significant changes in the shape of the vocal cords and trachea in patients with MPS were found. The most common abnormal configuration of trachea was the U-shape. The TSA was smaller in patients with MPS than in controls. The airway changes may be due to abnormal submucosal storage of substances such as keratan or dermatan sulfate. 相似文献
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The role of CT in staging radiographic T1N0M0 lung cancer 总被引:1,自引:0,他引:1
L R Heavey G M Glazer B H Gross I R Francis M B Orringer 《AJR. American journal of roentgenology》1986,146(2):285-290
Thirty-one patients with non-small-cell bronchogenic carcinoma and standard chest radiographs showing T1N0M0 tumors underwent preoperative chest and upper abdominal computed tomography (CT) with subsequent thorough surgical-pathologic correlation of their disease status. Eight patients (25.8%) had tissue-proven mediastinal or distant metastasis at presentation. In five (62.5%) of these eight patients the presence of unresectable disease was detected by CT and an unnecessary thoracotomy was avoided. These five patients comprised three with mediastinal lymph-node metastasis, one with adrenal metastasis, and one with a coexistent contralateral, proximal endobronchial tumor. Three patients with unresectable disease not detected by CT (CT false negatives) had metastasis to normal-sized mediastinal lymph nodes. There were two CT false-positive diagnoses of adrenal metastasis in patients proven by CT-guided aspiration to have benign adrenal masses, and these patients subsequently underwent curative lung resection. Although the data base is relatively small, the authors conclude that preoperative CT may be useful in evaluating patients with radiographic T1N0M0 lung cancer. 相似文献
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All chest radiographs of 107 proven lung cancer patients who received consecutive biennial chest radiography were reviewed to elucidate problems detecting their cancers, and diagnosing them when initially radiographically detected. Subjects, members of a fixed population sample, originally numbered 20,000 persons, 17,000 of whom consistently received consecutive biennial chest radiography during examinations for late effects of atomic-bomb radiation. Among the 107 subjects, 64 had radiographic manifestations of cancer; 47 were initially correctly diagnosed; 17 were not. Eleven of the 17 were initially equivocal, diagnosable only after subsequent radiography and retrospective review of serial radiographs. Diagnostic problems consisted of 1) six detection errors with cancer images superimposed on musculoskeletal and cardiovascular structures, reducible by stereoscopic p.a. instead of single p.a. radiography; immediate tentative interpretations; and by comparing earlier with current radiographs. 2) Eight decision errors, wherein cancers mimicked other diseases, were reducible by greater index of suspicion and scrutiny during interpretations. 相似文献