Ramsey R G, Geremia G K
Department of Diagnostic Radiology and Nuclear Medicine, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
AJR Am J Roentgenol. 1988 Sep;151(3):449-54. doi: 10.2214/ajr.151.3.449.
AIDS is now a common disease, seen daily in large metropolitan medical centers. Neuroimaging techniques such as CT and MR are critical to the detection and diagnosis of CNS complications. Intracerebral infections are common. These infections frequently are caused by opportunistic organisms; less commonly, they are bacterial infections. The cranial imaging features on CT and MR are not pathognomonic, but their distribution or appearance (e.g., asymmetric target lesions of toxoplasmosis) may have predictive value in a known AIDS patient. The superior contrast resolution of MR makes it a more sensitive cross-sectional imaging tool for evaluating intracerebral abnormalities associated with a variety of infectious processes. Differential diagnoses still include metastatic disease, lymphoma, and infarcts. When MR is used as the initial cross-sectional imaging study, contrast-enhanced CT may still be necessary to further characterize a lesion. Currently, more experience exists with CT for follow-up of the AIDS patient with CNS manifestations. MR, particularly with gadolinium-DTPA as a contrast medium, will probably become the imaging method of choice.
艾滋病如今已成为一种常见疾病，在大型都市医疗中心每天都能见到。诸如CT和MR等神经影像学技术对于中枢神经系统并发症的检测和诊断至关重要。脑内感染很常见。这些感染通常由机会性生物体引起；较少见的情况下，是细菌感染。CT和MR上的头颅影像学特征并无特异性，但它们的分布或表现（例如，弓形虫病的不对称靶形病变）在已知的艾滋病患者中可能具有预测价值。MR优越的对比分辨率使其成为评估与各种感染性过程相关的脑内异常的更敏感的横断面成像工具。鉴别诊断仍包括转移性疾病、淋巴瘤和梗死。当将MR用作初始横断面成像研究时，可能仍需要增强CT来进一步明确病变特征。目前，对于有中枢神经系统表现的艾滋病患者的随访，CT有更多的经验。MR，尤其是使用钆喷酸葡胺作为造影剂时，可能会成为首选的成像方法。
