艾滋病合并弓形虫脑病的MRI表现及随访

目的探讨艾滋病患者合并弓形虫脑病的MRI影像学表现以及治疗后MRI随访影像学表现。方法收集12例艾滋病合并弓形虫脑病患者的临床及MRI影像学资料,以及治疗后MRI影像随访资料,回顾性分析患者发病时及治疗后头颅MRI影像表现特点。结果 12例艾滋病患者合并弓形虫脑病一共发现颅内病灶58个,每个患者颅内病灶数目为1-16个不等,其中结节状或类圆形病灶共39个。所有颅内病变MR T1WI表现为低或高信号,T2WI表现为高或等低信号,增强MRI有24个病灶呈环形强化,其中3个病变表现为"靶征"。经过抗弓形虫治疗后2个月,7例患者可见病变明显吸收,周围水肿消退;5例半年后患者仍然有少量病变残留;一年后3例患者MRI随访基本恢复正常,但依然可见病变残留。结论艾滋病合并弓形虫脑病患者颅内病灶MRI影像表现为多灶性,多累及大脑额叶、基底节区;病灶的形态多为结节状或类圆形,增强后MRI以环形强化为主。经过抗弓形虫治疗后,大部分病灶短时间内明显吸收,小部分病灶可长时间残留。

MRI Imaging Findings and Follow up of AIDS Patients with Toxoplasma Encephalopathy

Objective The purpose was to characterize the MRI imaging findings and MRI follow up of toxoplasma encephalopathy in AIDS patients. Methods A retrospective review of 12 human AIDS patients with Toxoplasma encephalopathy was performed. Brain MRI of the patients and clinical data were reviewed. Results There were total 58 intracranial lesions found in 12 patients, the number of lesions per patient ranged from 1 to16, all lesions showed hyperintense or isointense in T2WI and hypointense or hyperintense in T1WI, peripheral rim enhancement was seen in 24 lesions. After 2 months treatment, absolutely absorption was found in 7 patients, and partly left was found in 5 patients after 6 months, the longest duration of lesion was one year in 3 patients. Conclusion The intracranial lesions were multifocal in AIDS patients with Toxoplasma encephalopathy, involving mostly the frontal lobe and basal ganglia region. Most of the lesions were nodular or round shaped with peripheral rim enhancement. After the treatment of Toxoplasma gondii, most of the lesions absorbed in a early time, and a small number of the lesions left for a long time.