立体定向活检术在AIDS伴发颅内病变诊断中的应用

The Application of Stereotactic Biopsy for the Diagnosis of Intracranial Lesion in Patients with AIDS

目的总结立体定向活检术协助诊断AIDS伴发颅内病变的经验，探讨手术方法、技术要点和降低手术并发症及提高阳性诊断率的方法。方法回顾性分析6例AIDS伴发颅内占位性病变患者的临床资料。其中男3例，女3例；年龄15—49（平均37．3）岁；病史10d～1年。均行核磁共振定位立体定向脑活检术，活检标本术后行常规病理学检查，必要时行免疫组化检查。结果6例患者手术顺利，病理结果示：炎症3例，星形细胞瘤1例，弓形虫脑病1例，胶质细胞增生1例。术后随访8个月一4年，1例完全康复，4例症状明显好转，1例死亡。结论立体定向活检术协助诊断AIDS伴发颅内病变安全、有效，有助于制定治疗方案和改善预后。

Objective To summarize our experiences of stereotactic biopsy for the diagnosis of intracranial lesions in patients with AIDS. To explore operation methods and technical points, decrease complications and increase positive diagnostic rate. Methods 6 AIDS patients（3 males and 3 females）with multiple intraeranial lesions under- went stereotactic biopsy were analyzed retrospectively. The patients were 15 to 49 years （ mean 37.5 years） old and disease history ranged from 10 days to 1 year. Patients underwent MRI guided stereotactic brain biopsy. Pathological examination was taken after operation and immunohistochemical examination was taken if necessary. Results Opera- tions for 6 patients were successful. Pathology results showed ： inflammation in 3 cases, astrocytoma in 1 case, toxoplas- mic encephalitis in 1 case, glial cells hyperplasia in 1 case. Patients were followed up from 8 months to 4 years. 1 case fully recovered,4 cases with significant improvement in symptoms and 1 died. Conclusion Stereotactic biopsy is a safe and effective way for the diagnosis of intracranial lesions in AIDS, which is helpful for making treatment plan and improve prognosis.