AIDS合并免疫重建炎性综合征肺结核感染的胸部CT表现

The Chest CT Imaging in Diagnosis of Tuberculosis-Associated Immune Reconstitution Inflammatory Syndrome

目的分析获得性免疫缺陷综合征(AIDS)患者经过高效抗逆转录病毒治疗(HAART)后发生免疫重建炎性综合征(IRIS)肺结核感染的胸部CT表现特点。方法回顾性分析30例经高效抗逆转录病毒治疗后发生IRIS的AIDS患者的胸部CT图像及临床资料探讨其特征性表现。结果 30例患者中肺内出现弥漫性病变伴结节影20例,出现肺内结节影、条片影17例,粟粒性肺结核15例,纵隔、肺门淋巴结肿大10例,胸腔积液15例,心包积液10例。结论两肺弥漫病变伴粟粒样结节影是AIDS发生IRIS结核病感染最显著的胸部CT影像表现特点,可伴或不伴淋巴结肿大或胸腔积液或心包积液。

Objective The analysis of acquired immune deficiency syndrome（ Acquired Immunodeficiency Syndrome,AIDS） Patients with highly active antiretroviral therapy（ Highly Active Anti-Retroviral Therapy HAART） After the immune reconstitution inflammatory syndrome（ Immune Reconstitution Inflammatory Syndrome,IRIS） Chest CT manifestation of tuberculosis infection. Methods Retrospective analysis of 30 cases occurred after highly active antiretroviral therapy immune reconstitution inflammatory syndrome（ HIV / AIDS The chest CT images and clinical data had beeninvestigated. Results Occurrence in 30 cases of patients,20 showed pulmonary diffuse lesions,17 cases showd nodular shadows,15 casesshowed miliary tuberculosis of the lungs,with 10 cases of mediastinal and the lung lymph node,Pleural effusion in 15 cases,and 10 cases of pericardial effusion. Conclusion In diffuse lesions in the lungs with miliary nodular shadows is the most significant features of chest CT imaging findings in IRIS. It can be with or without lymph node enlargement or pleural effusion and pericardial effusion as well.