[采用铊-201进行脑单光子发射计算机断层扫描在艾滋病患者局灶性脑病变鉴别诊断中的应用]
[Cerebral SPECT with thallium-201 in the differential diagnosis of focal cerebral lesions in patients with AIDS].
作者信息
Sanjaume M, Rodríguez-Carballeira M, Mauri E, Martínez-Lacasa J, García J R, Garau J
机构信息
Servicio de Medicina Interna, Hospital Mútua de Terrassa, Barcelona.
出版信息
Enferm Infecc Microbiol Clin. 1997 Jan;15(1):28-31.
BACKGROUND
The aim of this study was to analyze the usefulness of cerebral SPECT with thallium-201 in patients with the acquired human immunodeficiency syndrome (AIDS) and focal cerebral lesions.
METHODS
Six patients with AIDS and focal cerebral lesions in whom a cerebral SPECT was performed with thallium-201 are described. Treatment was initiated with antiToxoplasma drugs in all patients. The clinical response, serology for positive toxoplasma and radiologic improvement were criteria for the diagnosis of encephalitis by Toxoplasma. In the remaining cases, cerebral biopsy and/or necropsy study were carried out.
RESULTS
In the 2 patients in whom cerebral SPECT demonstrated enhancement of the lesion, the pathologic diagnosis was cerebral lymphoma. Of the 4 remaining cases in whom no enhancement was observed, three corresponded to cerebral toxoplasmosis and one to progressive multifocal leucoencephalopathy.
CONCLUSIONS
Cerebral SPECT with thallium-201 is a simple, specific and useful technique for the differentiation of primary cerebral lymphoma from the remaining inflammatory cerebral lesions which may be present in AIDS patients.
背景
本研究的目的是分析用铊-201进行脑单光子发射计算机断层扫描（SPECT）对获得性人类免疫缺陷综合征（AIDS）合并局灶性脑病变患者的有效性。
方法
描述了6例AIDS合并局灶性脑病变且接受铊-201脑SPECT检查的患者。所有患者均开始使用抗弓形虫药物治疗。临床反应、弓形虫血清学阳性及影像学改善是诊断弓形虫脑炎的标准。其余病例进行了脑活检和/或尸检研究。
结果
在2例脑SPECT显示病变强化的患者中，病理诊断为脑淋巴瘤。其余4例未观察到强化的病例中，3例为脑弓形虫病，1例为进行性多灶性白质脑病。
结论
用铊-201进行脑SPECT是一种简单、特异且有用的技术，可用于鉴别AIDS患者可能出现的原发性脑淋巴瘤与其余炎症性脑病变。
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