摘要
目的探讨获得性免疫缺陷综合征(AIDS)合并颅内弓形虫感染的MRI表现特征。方法回顾性分析30例AIDS并颅内弓形虫感染的MRI平扫、DWI和增强表现,随访观察影像学变化。结果 30例共发现128个病灶,其中7例单发,23例多发。MRI平扫时病灶呈斑片状、结节状和团块状,周围不同程度水肿。T_1WI呈低至中等信号,边缘可见高信号环;T_2WI呈中等到高信号,边缘可见低信号环;FLAIR多呈高信号,DWI呈等或稍高信号。增强后25个病灶呈斑片状强化,32个呈结节样强化,36个呈环状强化,27个呈靶样强化,3个呈螺旋状强化,6个未见明显强化。3例环状强化合并壁结节,6例合并脑膜强化,1例累及室管膜。结论 AIDS合并颅内弓形虫感染MRI表现有一定的特征性,MRI可监测病情进展,随访病情转归。
Objective To explore MRI manifestations of toxoplasmosis encephalitis in acquired immune deficiency syndrome (AIDS)patients.Methods MRI findings of plain scans,DWI and enhanced scans of 30 AIDS patients complicated with toxoplasmosis encephalitis were retrospectively analyzed.The MR imaging changes were observed for 3 to 18 months follow-up.Results 128 lesions with 7 cases of multiple lesions and 8 cases of the single lesion were found in 30 patients.The lesions demonstrated patchy,nodular and crumby,surrounded with varying degrees of edema in MRI plain scan.The lesions displayed low to medium signal intensity with hyperintensity rings on T_1WI,medium to high signal intensity with hypointensity rings on T_2WI,hyperintensity on FLAIR,and iso-or slightly hyperintensity on DWI.25 lesions showed patchy enhancement,32 showed nodular enhancement,36 showed ring-like enhancement,27 showed target-like enhancement,3 showed spiral enhancement and 6 showed no obvious enhancement.3 cases with ring-like enhancement were found mural nodules,6 cases were a complicated meningeal enhancement and 1 case was involved with ependymal.Conclusion The MRI manifestations of intracranial toxoplasma infection in AIDS have certain characteristics and MRI can be used to monitor the progression and follow-up the prognosis.
引文
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