ACQUIRED IMMUNODEFICIENCY SYNDROME - CEREBRAL COMPUTED TOMOGRAPHIC MANIFESTATIONS
ACQUIRED IMMUNODEFICIENCY SYNDROME - CEREBRAL COMPUTED TOMOGRAPHIC MANIFESTATIONS
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DOI：
10.1148/radiology.149.2.6622692
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发表时间：
1983-01-01
期刊：
影响因子：
19.7
通讯作者：
LAUBENSTEIN, L
中科院分区：
文献类型：
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作者：
WHELAN, MA;KRICHEFF, II;LAUBENSTEIN, L
对19例获得性免疫缺陷综合征（AIDS）患者进行了CNS CT [计算机断层扫描]检查。18例患者为同性恋者，5例为药物滥用者。脑实质和脑膜炎症见于颅内表现的患者。最常见的实质病变是弓形虫病，表现为环形强化、实性强化和无强化的局灶性水肿。最常见的脑膜炎是巨球菌病，通过脑脊液检查诊断，CT检查无特异性改变。弓形虫病和隐球菌病应该是有神经系统检查结果的患者的第一诊断考虑因素，这些患者有同性恋和/或静脉注射药物滥用史，既往有不寻常的感染或无反应史。延迟对比扫描，单次或双次剂量，似乎是最准确的方法，概述了总的疾病范围，从而帮助定位最佳活检部位的预处理诊断。在CT表现与弓形虫病一致且活检仅显示非特异性脑炎的病例中，建议采用经验性弓形虫病治疗。没有必要对每个实质病变都进行活检。
CT [computed tomography] examination of the CNS was performed in 19 patients with acquired immunodeficiency syndrome (AIDS). Eighteen patients were homosexuals, and 5 drug abusers. Parenchymal and meningeal inflammations were seen in patients with intracranial manifestations of the disease. The most common demonstrable lesion in the parenchyma was toxoplasmosis, which produced ring enhancement, solid enhancement, and nonenhancing focal edema. The most common meningeal inflammation was cruptococcosis, which was diagnosed by examination of the CSF and did not show specific CT changes. Toxoplasmosis and cryptococcosis should be the 1st diagnostic consideration in patients with neurologic findings who have a history of homosexuality and/or i.v. drug abuse and previous unusual infections or anergy. A delayed contrast scan, single or double dose, appears to be the most accurate method of outlining the total extent of disease, thereby helping to locate the best biopsy site for pretreatment diagnosis. Empirical institution of toxoplasmosis therapy is recommended in those cases in which CT findings are consistent with toxoplasmosis and the biopsy shows only nonspecific encephalitis. A biopsy of every parenchymal lesion is not considered necessary.