Meltzer C C, Wells S W, Becher M W, Flanigan K M, Oyler G A, Lee R R
Department of Radiology, University of Pittsburgh Medical Center, Pa 15213, USA.
AJNR Am J Neuroradiol. 1998 Jan;19(1):83-9.
Our goal was to describe the MR imaging appearance and clinical pathologic correlates of bilateral basal ganglia hyperintensity in acquired immunodeficiency syndrome (AIDS).
Medical records and laboratory data were reviewed retrospectively in nine cases of bilateral basal ganglia hyperintensity on long-repetition-time MR images. Opportunistic infections of the central nervous system were excluded by clinical and laboratory data. Postmortem neuropathologic examination was obtained in two cases.
All patients presented acutely with new seizures or changes in mental status. A history of drug abuse was elicited in seven of the nine remaining patients. Renal failure was present in six cases. Symmetric bilateral caudate and putamen hyperintensity on T2-weighted images was found in all cases with variable extension to the surrounding white matter, thalamus, and brain stem. Postmortem neuropathologic examination in two cases revealed numerous microinfarcts in a distribution similar to the MR signal abnormalities.
The MR appearance of basal ganglia hyperintensity in this series of AIDS patients represents ischemic tissue injury. We propose that this clinicopathologic entity is precipitated by the combined effects of human immunodeficiency virus infection and drug use, particularly cocaine and/or associated toxic contaminants.
我们的目标是描述获得性免疫缺陷综合征（AIDS）中双侧基底节高信号的磁共振成像表现及临床病理相关性。
回顾性分析9例在长重复时间磁共振图像上出现双侧基底节高信号患者的病历和实验室数据。通过临床和实验室数据排除中枢神经系统机会性感染。2例患者进行了尸检神经病理学检查。
所有患者均急性出现新发癫痫或精神状态改变。其余9例患者中有7例有药物滥用史。6例患者存在肾衰竭。所有病例在T2加权图像上均发现双侧尾状核和壳核对称性高信号，不同程度地延伸至周围白质、丘脑和脑干。2例尸检神经病理学检查显示分布与磁共振信号异常相似的大量微梗死灶。
该系列AIDS患者基底节高信号的磁共振表现代表缺血性组织损伤。我们认为这种临床病理实体是由人类免疫缺陷病毒感染和药物使用，特别是可卡因和/或相关有毒污染物的联合作用所致。
