Vanarthos W J, Ganz W I, Vanarthos J C, Serafini A N, Tehranzadeh J
Department of Diagnostic Radiology, Jackson Memorial Hospital, Miami.
Radiographics. 1992 Jul;12(4):731-49; discussion 749-52. doi: 10.1148/radiographics.12.4.1636036.
Radionuclide imaging, if applied with an organ system approach, is useful in the diagnosis of the AIDS (acquired immunodeficiency syndrome)-related complex. Specific pathologic processes can be suspected on the basis of uptake patterns. The intensity and pattern of pulmonary uptake and concomitant nonpulmonary uptake of gallium provide guidelines for distinguishing among various opportunistic pulmonary pathogens. Gastrointestinal and extra-gastrointestinal tract uptake of gallium aids distinction among fungal, mycobacterial, and viral infections and neoplasms. Patterns of spleen uptake of technetium-99m sulfur colloid and gallium allow differentiation between neoplasm (Kaposi sarcoma) and infection (with mycobacteria). Skeletal and soft-tissue abnormalities can be characterized and differentiated on the basis of bone scan and other radionuclide scan findings. Thallium uptake in brain tumors (and not in areas of infection) allows brain lesion discrimination. In the proper clinical setting, AIDS nephropathy has a characteristic gallium uptake pattern. Cardiac abnormalities (including functional) can also be assessed with scintigraphy. With knowledge of these organ-specific patterns and with correlative imaging studies, the manifestations of AIDS can be differentiated and appropriate treatment instituted.
放射性核素成像如果采用器官系统方法应用，对于获得性免疫缺陷综合征（AIDS）相关综合征的诊断很有用。根据摄取模式可以怀疑特定的病理过程。肺部镓摄取的强度和模式以及伴随的非肺部摄取为区分各种机会性肺部病原体提供了指导。镓在胃肠道和胃肠道外的摄取有助于区分真菌、分枝杆菌和病毒感染及肿瘤。锝-99m硫胶体和镓在脾脏的摄取模式可区分肿瘤（卡波西肉瘤）和感染（分枝杆菌感染）。骨骼和软组织异常可根据骨扫描和其他放射性核素扫描结果进行特征描述和区分。脑肿瘤（而非感染区域）对铊的摄取可用于鉴别脑部病变。在适当的临床情况下，艾滋病肾病有特征性的镓摄取模式。心脏异常（包括功能异常）也可用闪烁扫描术评估。了解这些器官特异性模式并结合相关成像研究，可区分艾滋病的表现并进行适当治疗。
