艾滋病合并颅内结核的影像诊断新进展

doi:10.19871/j.cnki.xfcrbzz.2023.04.018

摘要/Abstract

摘要： 我国结核病患病人数逐年增加,艾滋病患者免疫力低下,往往更容易合并结核病,双重机会性感染会加重病情,增加死亡率。近年来,艾滋病合并颅内结核患病人数有所增加,临床多通过免疫学检测和影像学技术辅助诊断,其中,影像诊断是艾滋病合并颅内结核的首选诊断方法,通过早期诊断和及时治疗可以改善HIV感染及其并发症的病情;艾滋病合并颅内结核包括脑膜结核、脑实质结核和混合型脑结核,其中脑实质结核包括结核性脑炎、脑结核瘤和结核性脑脓肿。艾滋病合并颅内结核的影像学表现与患者的特异性CD4⁺T淋巴细胞数量密切相关,当感染患者CD4⁺T淋巴细胞数在100个/μl以下时,颅内结核病灶多分布于大脑皮质下的脑实质为主;每种类型的颅内结核不同阶段都有特征性的影像学表现。艾滋病合并颅内结核的并发症通常包括脑积水、血管炎、脑梗死等。当感染患者CD4⁺T淋巴细胞数在100个/μl以上时,与非HIV感染引起的颅内结核表现无明显区别。本文旨在综述艾滋病合并颅内结核的影像诊断新进展,提高该疾病的诊断水平。

关键词: 艾滋病, 颅内结核, 影像诊断

Abstract: The number of tuberculosis patients in China has increased year by year, AIDS patients with low immunity are more likely to be complicated with tuberculosis, which can worsen their condition and increase the likelihood of mortality. In recent years, there has been a rise in cases of intracranial tuberculosis among HIV patients. These cases are typically diagnosed using immunological tests and imaging techniques. Among them, imaging diagnosis is the first choice for diagnosis of AIDS complicated with intracranial tuberculosis. Through early diagnosis and timely treatment, HIV infection and its complications can be improved. AIDS complicated with intracranial tuberculosis includes, tuberculoma of the brain, and tuberculous brain abscess. Imaging results for HIV intracranial TB are closely linked to the patient's CD4⁺ T lymphocyte count.When the infected patient has a CD4⁺ T lymphocyte count below 100 cells/μl, the intracranial TB lesions are predominantly subcortical parenchymal lesions; each type of intracranial tuberculosis has characteristic imaging presentations at different stages. Complications of AIDS complicated with intracranial tuberculosis usually include hydrocephalus, vasculitis, and cerebral infarction. When the CD4⁺ T lymphocyte count in infected patients is above 100 cells/μl, there is no clear distinction between the presentation of intracranial TB and that caused by simple infection. The aim of this article is to review the advances in diagnostic imaging of intracranial tuberculosis infection in AIDS and to improve the diagnosis of this disease.

Key words: Acquired immune deficiency syndrome, Intracranial tuberculosis infection, Diagnostic imaging

中图分类号:

许承志, 农恒荣. 艾滋病合并颅内结核的影像诊断新进展[J]. 新发传染病电子杂志, 2023, 8(4): 90-94.

Xu Chengzhi, Nong Hengrong. New advances in medical imaging diagnosis of AIDS complicated with intracranial tuberculosis[J]. Electronic Journal of Emerging Infectious Diseases, 2023, 8(4): 90-94.

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