Yeo K K, Yeo T T, Chan C Y, Sitoh Y Y, Teo J, Wong S Y
Department of Neurosurgery, National Neuroscience Institute, Tan Tock Seng, Singapore.
Singapore Med J. 2000 Apr;41(4):161-6.
To assess the usefulness of stereotactic brain biopsies in AIDS patients with cerebral lesions in Singapore.
A total of 10 patients with AIDS and cerebral lesions underwent stereotactic brain biopsies in the Department of Neurosurgery, Tan Tock Seng Hospital (TTSH) between September 1997 and September 1998. The patients were referred from the Communicable Diseases Centre (CDC), TTSH. These patients either failed a trial of therapy for toxoplasmosis encephalitis (TE) or had CT/MRI scans which did not suggest TE. Four were CT-guided and six were MRI-guided stereotactic biopsies. The Radionics Cosman-Robert-Wells (CRW) stereotactic apparatus was used for all cases.
The male to female ratio was 9:1. Histological diagnosis from biopsy was lymphoma (5), metastatic adenocarcinoma (1), TE (1), abscess (1), encephalitis (1) and granulomatous tissue (1-presumed tuberculosis).
The early experience is that stereotactic brain biopsy is useful in patients with AIDS and cerebral lesions. The etiology is confirmed in the majority of cases and impacts on management decisions and prognostication.
评估立体定向脑活检在新加坡艾滋病合并脑损害患者中的应用价值。
1997年9月至1998年9月期间，共有10例艾滋病合并脑损害患者在新加坡樟宜综合医院神经外科接受了立体定向脑活检。这些患者由樟宜综合医院传染病中心转诊而来。这些患者要么接受抗弓形虫脑炎（TE）治疗试验失败，要么其CT/MRI扫描结果不提示为TE。4例为CT引导下立体定向活检，6例为MRI引导下立体定向活检。所有病例均使用Radionics Cosman-Robert-Wells（CRW）立体定向装置。
男女比例为9:1。活检组织学诊断为淋巴瘤（5例）、转移性腺癌（1例）、TE（1例）、脓肿（1例）、脑炎（1例）和肉芽肿组织（1例 - 推测为结核）。
早期经验表明，立体定向脑活检对艾滋病合并脑损害患者有用。在大多数病例中可明确病因，并对治疗决策和预后判断有影响。
