摘要
目的探讨MRI在AIDS合并弓形虫脑病诊断中的应用价值。方法回顾性收集17例AIDS合并弓形虫脑病患者的MR资料,分析其征象特点。并根据抗弓形虫治疗后患者中枢神经系统症状改变,将患者分为预后良好组(n=10)及预后不良组(n=7),比较两组间MRI表现差异。结果①弓形虫脑病病灶为多发;②病灶分布弥漫,幕上、幕下均可见,最常见于脑叶皮髓质交界区、丘脑-基底节区;③病灶多呈结节状,病灶周围常伴有大范围水肿;④病灶信号主要表现为T1WI低信号,T2WI高信号,部分病灶内可见T1WI高信号、T2WI低信号,增强扫描病灶多呈环形强化。部分病灶T2WI、FLAIR及增强扫描可见“靶征”;⑤病灶体积大、病灶内出血征象组间比较差异有显著统计学意义(χ^2值分别为14.405,14.912,P<0.05)。结论AIDS合并弓形虫脑病MR表现具有一定特点,部分征象可提示预后不良。
Objective To evaluate the value of MR in diagnosis of toxoplasmic encephalitis.Methods A retrospective study of 17 AIDS patients with toxoplasmic encephalitis who underwent MRI examination.MR findings of these patients were described.According to the changes of the central nervous system symptoms after treatment,the cases were divided into two groups,including a group with favorable outcomes(n=10)and another group with poor outcomes(n=7).Results①Multiplelesion was a common finding for toxoplasmic encephalitis.②Lesions distributed diffusely,could be detected in both supratentorial and subtentorial areas,and could be most commonly found in both the boundary area of cortex and medulla,and the thalamus-basal ganglia area.③The majority of lesions presented as nodules,with wide edema.④Lesions were mainly of hypo intensity on T1WI images and hyper intensity on T2WI images.The opposite signal intensity could be detected in certain lesions with hemorrhage.On contrast enhanced images,the lesions showed ring-like enhancement.Target sign can be detected on T2WI,FLAIR and contrast enhanced images.⑤Oversize and hemorrhage might be signs for poor outcome according to the statistical analysis(χ^2=14.405 and 14.912,respectively,P<0.05).Conclusion MR is important in diagnosis of toxoplasmic encephalitis in AIDS patients,and some signs may indicate poor prognosis.
作者
闫铄
李晶晶
谢汝明
YAN Shuo;LI Jing-jing;XIE Ru-ming(Department of Radiology,Beijing Di-Tan hospital,Capital Medical University,Beijing 100051,China)
出处
《新发传染病电子杂志》
2016年第1期27-30,共4页
Electronic Journal of Emerging Infectious Diseases
关键词
艾滋病
弓形虫脑病
MRI
Acquired immunodeficiency syndrome
Toxoplasmic encephalitis
Magnetic resonance imaging
