Trotot P M, Gray F
Department of Radiology, Institut Pasteur Hospital, Paris, France.
Neuroimaging Clin N Am. 1997 May;7(2):243-60.
The neuropathology of full-blown, symptomatic AIDS, established in many large autopsy series, has been described in great detail and is now universally accepted. In contrast, the natural history of the changes occurring in the central nervous system during the earlier states of HIV-1 infection remains poorly understood. With specific regard to MR imaging, structural abnormalities have been reported early in the course of the illness, with variable incidence, making it difficult to appreciate the significance of these findings, in particular for neurologically asymptomatic individuals. This article analyzes successively neuropathologic studies at the early stages of brain involvement by HIV and shows how imaging techniques contribute to the understanding of what is going on during the so-called "asymptomatic" period, lasting from seroconversion to symptomatic AIDS. The complementary use of clinical imaging and new technical modalities, such as proton spectroscopy MR imaging or functional MR imaging, will provide more specific and sensitive analyses. Animal studies also will contribute in the future by providing a better knowledge of the natural history of the illness and providing a means for testing the efficacy of new medication.
在许多大型尸检系列研究中已明确的、典型的、有症状的艾滋病神经病理学，已有详细描述且现已被普遍接受。相比之下，人们对HIV-1感染早期中枢神经系统发生的变化的自然史仍知之甚少。具体到磁共振成像（MR成像），在病程早期就已报告有结构异常，但其发生率各不相同，这使得难以评估这些发现的意义，尤其是对于没有神经症状的个体。本文相继分析了HIV感染脑部早期阶段的神经病理学研究，并展示了成像技术如何有助于理解从血清转化到出现症状性艾滋病的所谓“无症状”期内发生的情况。临床成像与新技术手段（如质子磁共振波谱成像或功能磁共振成像）的互补应用，将提供更具体、更敏感的分析。动物研究未来也将有所贡献，通过更好地了解疾病的自然史并提供测试新药疗效的方法。
