AIDS脑部病变影像学表现分析

目的总结AIDS脑部病变影像学表现,为AIDS脑部病变的影像诊断提供依据。方法回顾性分析19例神经系统型AIDS患者脑部CT和MRI表现。结果5例HIV脑炎中,3例表现为双侧大脑半球白质区对称性异常信号,2例表现为脑萎缩。2例弓形体脑炎影像学表现为基底节区和额顶叶多发密度或/和信号异常,增强T1WI呈多发环状高信号。3例脑淋巴瘤分别表现为双侧大脑半球单发或多发结节,周围伴水肿,增强T1WI呈结节状或不均匀强化。3例脑梗塞表现为基底节区局限性低密度影。2例进行性多灶性白质脑病表现为额顶叶脑白质区多发斑片状异常信号。1例霉菌感染表现为脑干信号异常,增强T1WI呈环状强化;1例霉菌性脑膜炎和2例单纯颅内压增高患者,影像学无异常表现。结论CT和MRI检查可以发现大部分AIDS脑部病变,并可根据影像学表现和其它相关检查做出定性诊断。

Analysis of Imaging Appearances of Brain Lesions in AIDS Patients

Objective To summarize imaging appearances of brain in AIDS patients,as to supply the evidences of imaging diagnosis for this disease . Methods CT or/and MRI appearances of brain in 19 patients with AIDS of nervous system type were reviewed . Results 3 cases showed the symmetry signal abnormal in bilateral whiter matter and 2 cases showed brain atrophy in 5 patients with HIV encephalitis.2 cases of toxoplasma encephalitis appeared multiple abnormal density or/and signal intensity in the brain and multiple ring enhancement . 3 patients with lymphoma displayed single or multiple nodule in the brain and nodular-enhancement or inhomogenous enhancement.3 patients with brain infarction displayed lower density in the basal ganglia on CT.2 patients with progressive multifocal leukoencephalopathy displaied multiple patch abnormal signal intensity of the white matter in frontal and parietal lobus.1 patient with cryptococcal infection showed abnormal signal and ring enhancement of the pons.1 patient with cryptococcal meningitis and 2 patients with intracranial hypertension had not abnormal imaging appearances.Conclusion Most lesions of the brain in AIDS patient may be detected by CT and MRI,but the definite diagnosis is still in need of combining with clinical appearances and other relative examination.