艾滋病合并腹部病变的影像学表现

Abdominal imaging in AIDS patients

目的探讨艾滋病(AIDS)合并腹部病变的影像学表现。方法回顾性分析6例 AIDS合并腹部病变影像学表现(包括超声、CT 和 MR 扫描)。全部病例均做了超声和胸腹部 CT 扫描(其中4例做了腹部 CT 增强扫描),1例做了胸腹部 MR 增强扫描。结果 6例中腹部结核4例,包括腹腔淋巴结结核3例和胰腺结核1例,皆伴有其他部位结核。腹腔淋巴结结核典型 CT 表现为增大的腹膜后淋巴结中央低密度改变,增强后呈环状强化;胰腺结核的 CT 表现为胰头低密度灶,增强后病灶周围轻度强化。播散性卡波西肉瘤1例,胸腹部 CT 及 MR 扫描表现为沿增粗的支气管血管束和肝内门静脉周围分布的肿瘤病灶。盆腔恶性肿瘤1例,CT 显示盆腔内占位病灶,壁不规则增厚,中央大面积低密度液化坏死区。结论 AIDS 合并腹部病变可表现为机会性感染和相关的恶性肿瘤,影像表现对诊断非常有帮助。组织活检可确定诊断。

Objective To evaluate abdominal imaging in AIDS. Methods The imaging examinations （including US, CT and MR） of 6 patients with AIDS associated abdominal foci were analysed retrospectively. All the cases were performed US, and CT scan, of which 4 performed enhanced CT scan and 1 with MR. Results Abdominal tuberculosis were found in 4 patients, including abdominal lymph nodes tuberculosis （3 cases） and pancreatic tuberculosis （1 case）. The imaging of lymph nodes tuberculosis typically showed enlarged peripheral rim enhancement with central los-attenuation on contrast-enhanced CT. Pancreatic tuberculosis demonstrated low-attenuation area in pancreatic head and slightly peripheral enhancement. Disseminated Kaposi＇s sarcoma was seen in 1 case： CT and MRI scan demonstrated tumour infiltrated along hepatic portal vein and bronchovascular bundles. Pelvic tumor was observed in 1 case： CT scan showed large mass with thick and irregular wall and central low attenuation liquefacient necrotic area in the pelvic cavity. Conclusion The imaging findings of AIDS with abdominal foci is extraordinarily helpful to the diagnosis of such disease. Tissue biopsy is needed to confirm the diagnosis.