艾滋病并发软组织骨骼感染的X线和CT表现

X-ray and CT findings of soft tissue and bone infections secondary to acquired immunodeficiency syndrome

目的 探讨艾滋病（AIDS）并发软组织骨骼感染的X线和CT表现.方法 回顾性分析18例AIDS并发软组织骨骼感染的X线和CT表现.结果 18例AIDS并发软组织骨骼感染中,蜂窝织炎1例,CT表现为皮下斑片状密度增高影.软组织脓肿6例,CT表现为类圆形低密度灶,增强后呈环状强化.脓性肌炎1例,CT表现为不均匀低密度灶,增强后病灶边缘强化.脓毒性关节炎4例,其中膝关节病变3例,髋关节病变1例；X线平片示骨质破坏2例,正常2例；CT表现为骨质破坏3例,关节腔积液4例.骨髓炎9例,其中骨结核8例,包括椎体病变6例,X线和CT的主要表现为椎体骨质破坏,骨质增生,死骨形成,椎间隙变窄；肋骨病变3例,CT表现为膨胀性骨质破坏；髂骨、骶骼关节病变1例,X线和CT表现为骨质破坏,死骨形成,关节间隙增宽.股骨慢性化脓性骨髓炎1例,X线表现为骨质破坏,骨质增生硬化,骨膜反应.结论 软组织和骨骼感染是艾滋病常见并发症,影像检查对疾病的早期诊断和治疗具有重要意义.

Objective To summarize X-ray and CT findings of soft tissue and bone infections secondary to acquired immunodeficiency syndrome （AIDS）.Methods The data of X-ray and CT findings of soft tissue and bone infections in 18 patients with AIDS were retrospectively collected and analyzed.Results Of 18 patients with AIDS,the CT features of soft tissue demonstrated that subcutaneous patchy high density in 1 case which considered as cellulitis,round low density lesions with ring enhancement in 6 cases which considered as soft tissue abscesses,heterogeneous density lesions with peripheral enhancement in 1 case which considered as pyomyositis.Of 18 patients with AIDS,septic arthritis was found in 4 cases involving knee lesion in 3 cases and hip lesion.In the 4 case,the X-ray films showed bony destruction in 2 cases and the CT showed bone destruction in 3 cases and arthroedema in 4 cases.Of 18 patients with AIDS,osteomyelitis was found in 9 cases of which tuberculosis was considered in 8 cases and vertebral involvement in 6 cases.In the 9 cases,the X-ray films and CT displayed bony destruction,hyperostosis,small sequestra,and intervertebral space narrowing.Of 18 patients with AIDS,costal lesions were found in 3 cases in which the CT showed expandable bony destruction.Of 18 patients with AIDS,ilium and cacroihac joint lesions were found in 1 case in which the X-ray films and CT showed bony destruction,sequestra,and joint widening.Of 18 patients with AIDS,chronic pyogenic osteomyelitis of femur was found in 1 case in which the X-ray films showed bony destruction,hyperostosis osteosclerosis,and periosteal reaction.Conclusion The X-ray and CT features of soft tissue and bone infections secondary to AIDS are characterized.The X-ray and CT are useful tools to early diagnose soft tissue and bone infections secondary to AIDS.