Masdeu J C, Yudd A, Van Heertum R L, Grundman M, Hriso E, O'Connell R A, Luck D, Camli U, King L N
Department of Neurology, St. Vincent's Medical Center, New York, NY 10011.
J Nucl Med. 1991 Aug;32(8):1471-5.
Depression or psychosis in a previously asymptomatic individual infected with the human immunodeficiency virus (HIV) may be psychogenic, related to brain involvement by the HIV or both. Although prognosis and treatment differ depending on etiology, computed tomography (CT) and magnetic resonance imaging (MRI) are usually unrevealing in early HIV encephalopathy and therefore cannot differentiate it from psychogenic conditions. Thirty of 32 patients (94%) with HIV encephalopathy had single-photon emission computed tomography (SPECT) findings that differed from the findings in 15 patients with non-HIV psychoses and 6 controls. SPECT showed multifocal cortical and subcortical areas of hypoperfusion. In 4 cases, cognitive improvement after 6-8 weeks of zidovudine (AZT) therapy was reflected in amelioration of SPECT findings. CT remained unchanged. SPECT may be a useful technique for the evaluation of HIV encephalopathy.
在先前无症状的人类免疫缺陷病毒（HIV）感染者中，抑郁症或精神病可能是心因性的，与HIV引起的脑部病变有关，或两者皆有。尽管预后和治疗因病因不同而有所差异，但计算机断层扫描（CT）和磁共振成像（MRI）在早期HIV脑病中通常无异常发现，因此无法将其与心因性疾病区分开来。32例HIV脑病患者中有30例（94%）的单光子发射计算机断层扫描（SPECT）结果与15例非HIV精神病患者及6例对照者的结果不同。SPECT显示多灶性皮质和皮质下灌注不足。4例患者在接受齐多夫定（AZT）治疗6 - 8周后认知功能改善，这在SPECT结果的改善中得到体现。CT结果保持不变。SPECT可能是评估HIV脑病的一种有用技术。
