AIDS合并脑内、肺内机遇性感染的影象学诊断研究

Imaging diagnosis of AIDS complicated with intracerebral and intrapulmonary opportunistic infection

目的研究AIDS合并脑内、肺内机遇性感染的影像表现及其与AIDS确诊的相关性。方法101例AIDS患者中合并脑内(22例)和肺内(24例)机遇性感染者均经MRI检查,部分病人还经Gd-DTPA增强及CT扫描。结果在一些典型的合并脑内机遇性感染患者中,CT平扫显示脑实质内多发低密度区,增强后病变呈异常强化。MRI显示两侧大脑白质广泛长T1、长T2异常信号,个别病人伴少量出血,Gd-DTPA增强后,脑实质内病变呈多发环状、螺旋形明显异常强化。在典型的合并肺内机遇性感染患者中,CT示右肺大片状高密度区、左侧胸腔内积液。结论AIDS合并脑内、肺内机遇性感染的影像表现无特异性征象,确诊需靠血清HIV检验。

Objective To investigate the imaging findings of AIDS complicated with intracerebral and intrapulmonary opportunistic infection and the correlation with definite diagnoasis of AIDS.Methods 22 patietns with intracerebral opportunistic infection (ICOI) and 24 patients with intrapulmonary opportunistic infecetion(IPOI) in 101 patients with AIDS underwent MRI examinations.Partial patients underwent additional Gd- DTPA contrast enhancement and CT scans.Results In typical patients with ICOI,the lesions in cerebral parenchyma showed multiple low attenuation area on CT plain scan,which showed abnormal enhancement after contrast administration,on MRI the lesions in bilateral cerebral white matter presented as wide long T1 and T2 abnormal signals associated with little hemorrhage.After Gd- DTPA enhanced scans,the lesions in cerebral parenchyma appeared as multiple circular and/or spiral form abnormal enhancement.In a patient with IPOI,CT revealed large patchy high attenuation area in right lung and left hydrothorax.Conclusion Imaging findings of AIDS complicated with ICOI and IPOI are not specific so that the definite diagnosis needs depending on serum HIV test. [