aids脑部病变ct和mri表现及对比研究

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1、AIDS脑部病变CT和MRI表现及对比研究作者：CT·MR科张锦烜王磊任月玲古丽孜拉张克云娜迪热关伟锋孙伟东阿娜尔【摘要】　　目的总结AIDS患者脑部病变影像特征，对比和探讨CT和MRI的诊断价值及临床意义。方法分析61例AIDS患者的临床和影像资料，并将CT和MRI进行对照研究。结果(1)本组脑萎缩占78.7％；2.病变绝大部分为多发，多见“三多”征象，以顶额叶居多，占43.6％，大部分同时累及皮髓质，平扫大多呈斑片状，占位效应相对较轻，增强后大部分呈环状强化；(3)AIDS患者脑部病变在MRI上

2、可呈现多种颇具特征的征象，如圈套征、搭桥征等；(4)病变大多呈CT低密度，MRI大多T1WI呈低信号，T2WI及Flair呈高信号；弓形体脑病居多；(5)MRI平扫在阳性病例捡出、病变数目显示均多于CT平扫，所能观察到的征象也明显多于CT。结论(1)脑萎缩为AIDS脑部病变最早最多见的影像改变，主要源自HIV感染所致；(2)脑内多发、多部位、多种形态并存的“三多”征象，在AIDS脑部病变中具有较高的诊断价值；(3)对AIDS脑部病变MRI检查明显优于CT，Flair像应作为常规检查序列。【关键词】获

3、得性免疫缺陷综合症脑体层摄影术X线计算机磁共振成像对比研究17　　[Abstract]ObjectiveTosummarizetheCT&MRIfeaturesofbrainlesioninneurologicallysymptomaticpatientswithAIDS.TocomparedandevaluatedthediagnosticvaluesandclinicalsignificanceofCT&MRI.MethodsTheclinicaldataandCT&MR

4、Iimagesof61patientswithAIDSwereanalyzedandcompared.Results(1)Therewere48patientshavingencephalonatrophyin61cases(78.7%);(2)Thelesionsweremultifocalmostly(92%)andtherewere“threemany”features.Thepresencesoflesionsweremainlyobservedinlobusfroutalisandpare

5、talis(43.6%),themajorityinvolvingthegrayandwhitemattersimultaneously.SpeckleschistoseappearedonplainCT&MRI.Moreover,theoccupyingeffectwasrelativelylighter.Majorpartsassumedcyclicannularchangeafterenhancing;(3)ThebrainlesionsofpatientswithAIDSmaypre

6、sentvariouscharacteristicsymbolsonMRI,like“snare”or“bridgingandsoon;(4)Lesionsassumedlow-densitymostlyonCT.ThesignalofthelesionsonMRIwashypointenseonT1WI,however,mostlywashyperintenseonT2WIandFlair.Themajorityof52casesshowedencephalontoxoplasmosis;(5)T

7、henumberofbrainlesionsinspectedbyplainMRIwasmorethanitbyCT.WhatcanbeobservedonMRIturnedoutmoreonCTaswell.Conclusion(1)Encephalonatrophy17istheearliestobservedandmostcommonbrainlesionsofpatientswithAIDSonCT&MRI,originatingfromHIVmainly;(2)Itoccursfr

8、equentlywiththemulti-spotsandvariousformsofcoexistence,whichcanbecalled“threemany”features,havingthehighlydiagnosticvaluesinthebrainlesionsofpatientswithAIDS;(3)MRIissuperiortoCTininspectionofbrainlesionsofpatientswithAIDS.Also,flairuse