Weisberg L A, Greenberg J, Stazio A
Department of Neurology and Psychiatry, Tulane Medical Center, New Orleans, LA 70112.
Comput Med Imaging Graph. 1988 Nov-Dec;12(6):379-83. doi: 10.1016/0895-6111(88)90081-x.
The clinical and computerized tomographic (CT) findings in 10 patients with cerebral toxoplasmosis are reviewed. All patients with cerebral toxoplasmosis were homosexuals and/or intravenous drug users, and all patients had other manifestations of AIDS. Two presented with focal seizures, 4 presented with focal neurological deficit which progressively worsened, and 4 had evidence of diffuse neurological dysfunction (altered consciousness, generalized seizures). CT showed a single lesion in 3 patients and multiple lesions in 7 patients. Two patients had hypodense nonenhancing lesions(s). Eight patients had hypodense lesions with peripheral or nodular enhancement. The lesions were more commonly located in the cerebral hemispheres and subcortical gray matter nuclear masses (thalamus, basal ganglia). The finding of a hypodense lesion with a central slightly hyperdense noncalcified region that showed dense nodular homogeneous enhancement was quite characteristic of cerebral toxoplasmosis, but this pattern may also be seen in other neurological conditions including brain lymphomas.
对10例脑弓形虫病患者的临床及计算机断层扫描(CT)结果进行了回顾。所有脑弓形虫病患者均为同性恋者和/或静脉吸毒者,且所有患者均有艾滋病的其他表现。2例出现局灶性癫痫发作,4例出现逐渐加重的局灶性神经功能缺损,4例有弥漫性神经功能障碍(意识改变、全身性癫痫发作)的证据。CT显示3例患者有单个病灶,7例患者有多个病灶。2例患者有低密度无强化病灶。8例患者有低密度病灶伴周边或结节状强化。病灶更常见于大脑半球和皮质下灰质核团(丘脑、基底神经节)。发现低密度病灶伴有中央略高密度非钙化区且显示致密结节状均匀强化是脑弓形虫病的相当典型表现,但这种模式在包括脑淋巴瘤在内的其他神经系统疾病中也可见到。