艾滋病相关中枢神经系统隐球菌病：放射学与病理学相关性
AIDS-related CNS cryptococcosis: radiologic-pathologic correlation.
作者信息
Mathews V P, Alo P L, Glass J D, Kumar A J, McArthur J C
机构信息
Department of Radiology, Johns Hopkins Medical Institutions, Baltimore, Maryland.
出版信息
AJNR Am J Neuroradiol. 1992 Sep-Oct;13(5):1477-86.
PURPOSE
This study evaluates the effectiveness of cranial CT and MR in detecting autopsy findings of AIDS-related CNS cryptococcosis.
METHODS
Final imaging studies compared with pathology were CT in eight patients (five with contrast) and MR in five patients (all with Gd-DTPA).
RESULTS
Neither modality effectively identified cryptococcal meningitis. Punctate hyperintensities were seen in all patients with MR and corresponded pathologically to both perivascular spaces dilated by cryptococcal infection and cryptococcomas. Pathologically, cryptococcomas were more common than dilated perivascular spaces. MR detected more cryptococcomas than did CT, but both modalities underestimated the number of lesions seen at autopsy. Contrast enhancement of cryptococcomas and cryptococcal meningitis was uncommon.
CONCLUSIONS
CNS cryptococcosis was more effectively demonstrated by MR than by CT, but both modalities underestimated the pathologic extent of the disease. Cryptococcal lesion contrast enhancement was unusual possibly because of the immunocompromised state of our patients and the unique characteristics of the organism itself.
目的
本研究评估头颅CT和磁共振成像（MR）在检测艾滋病相关中枢神经系统隐球菌病尸检结果方面的有效性。
方法
与病理结果进行对比的最终影像学检查包括8例患者的CT（5例增强扫描）和5例患者的MR（均使用钆喷酸葡胺）。
结果
两种检查方式均不能有效识别隐球菌性脑膜炎。所有接受MR检查的患者均可见点状高信号，病理上对应于因隐球菌感染而扩张的血管周围间隙和隐球菌瘤。病理上，隐球菌瘤比扩张的血管周围间隙更常见。MR比CT检测到更多的隐球菌瘤，但两种检查方式均低估了尸检时所见病变的数量。隐球菌瘤和隐球菌性脑膜炎的强化不常见。
结论
MR比CT更能有效地显示中枢神经系统隐球菌病，但两种检查方式均低估了疾病的病理范围。隐球菌病变强化不常见，可能是因为我们的患者处于免疫抑制状态以及该病原体本身的独特特性。
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