Section of Neuroradiology, Department of Radiology, University of Miami Miller School of Medicine, Jackson Memorial Medical Center, Miami, FL 33136, USA.
AJNR Am J Neuroradiol. 2013 Jul;34(7):1308-18. doi: 10.3174/ajnr.A3184. Epub 2012 Jul 12.
While the previous review of CNS-IRIS in the HIV-infected patient on highly active antiretroviral therapy (Part 1) dealt with an overview of the biology, pathology, and neurologic presentation of this condition and a discussion of the atypical imaging findings in PML-IRIS and cryptococcal meningitis-IRIS due to the robust inflammatory response, the current review (Part 2) discusses the imaging findings in other commonly encountered organisms seen in association with CNS-IRIS, namely, VZV, CMV, HIV, Candida organisms, Mycobacterium tuberculosis, and Toxoplasma gondii. Also described is the imaging appearance of CNS-IRIS when not associated with a particular organism. Recognition of these imaging findings will give credence to the diagnosis of CNS-IRIS and will allow the clinician to institute changes in medical management, if necessary, so that immune reconstitution and improved patient outcome can occur with time.
在上一篇关于 HIV 感染者接受高效抗逆转录病毒治疗(第 1 部分)时中枢神经系统(CNS)免疫重建炎症综合征(IRIS)的综述中,我们讨论了该疾病的生物学、病理学和神经表现,并讨论了由于强烈炎症反应引起的朊病毒病(PML)IRIS 和隐球菌性脑膜炎(CM)IRIS 的非典型影像学表现,而本篇综述(第 2 部分)讨论了与 CNS-IRIS 相关的其他常见病原体(如单纯疱疹病毒(VZV)、巨细胞病毒(CMV)、HIV、念珠菌、结核分枝杆菌和刚地弓形虫)的影像学表现。同时还描述了与特定病原体无关的 CNS-IRIS 的影像学表现。识别这些影像学表现将有助于 CNS-IRIS 的诊断,并使临床医生能够在必要时调整医疗管理,如果随着时间的推移能够实现免疫重建和改善患者预后。