获得性肝性脑部变性的MRI表现

目的 描述获得性肝性脑部变性的脑部ＭＲ表现,评价ＭＲ对该病的诊断价值。方法 对２６例（男１７例,女９例）各种原因引起的慢性肝病肝功能衰竭患者进行了脑部ＭＲ检查,８例同时进行了腹部ＭＲ数字减影血造影（ＭＲＤＳＡ）。其中２５例在ＭＲ检查后２周内测定血管氨水平并对血氨水平与信号强度做统计学分析。结果 ２６例中２２例脑部有阳性发现,表达为自旋回波（ＳＥ）序列双侧苍白球（２／２６）、豆状核（４／２６）、中脑     

获得性肝性脑部变性的MRI表现

目的探讨获得性肝性脑部变性的MRI影像学特征及原因。方法对23例有精神神经症状的慢性肝硬化患者进行头颅MRI扫描,其中1例并行增强扫描,4例同时进行腹部扫描,分析其MRI征象。结果23例患者,22例脑部MRI有阳性发现,1例MRI表现阴性。双侧苍白球(22/22),豆状核(13/22),红核(9/22),垂体前叶(7/22),大脑脚盖(2/22)在自旋回波(SE)序列T1WI表现为高信号,快速自旋回波(FSE)T2WI信号正常,病灶区脑结构的体积、形态无变化。结论双侧基底节等部位出现T1WI高信号是获得性肝性脑部变性较为特征性的影像学表现,结合临床慢性肝硬化病史可确定诊断。     

中枢性尿崩症的脑部MRI表面（附27例报告）

探讨中枢性尿崩症的脑部ＭＲＩ诊断及相关性问题，报道了２７例ＤＩ患者的ＭＲＩ所见，９例通过手术证实，５例作过Ｇｄ－ＤＴＰＡ增强扫描，均采用ＳＥ系列，以ＤＩ的成因及其与脑ＭＲＩ的相关性进行探讨。     

获得性免疫缺陷综合征（AIDS）的脑部影像诊断

中枢神经系统在ＡＩＤＳ患者经常受累,引起不同疾病,可分为人类免疫缺陷病毒的侵犯,机遇性感染,肿瘤及血管病变,本文介绍这些病变的主要影像学表现,并结合病理,临床讨论其鉴别诊断。     

MRI诊断获得性肝性脑部变性的价值

目的:探讨获得性肝性脑部变性(AHCD)的脑部MRI表现特征,评价MRI对AHCD的诊断价值。方法:对18例经临床确诊为肝性脑病患者进行头颅MRI扫描,其中3例行增强扫描,4例同时行腹部MRI扫描,分析其MRI征象。结果:18例患者脑部MRI扫描均有阳性发现,主要显示基底节区信号强度对称性增高,双侧豆状核(18/18),中脑红核周围(16/18),垂体前叶(10/18)快速自旋回波(FSE)T1WI均表现为高信号,FES T2WI信号正常17例,高信号1例。18例T2FLAIR信号正常。病变区脑结构的体积、形态无变化。结论:MRI T1WI双侧基底节、中脑等部位出现高信号影,是AHCD较为特征性的影像学表现,MRI是发现这些病变最敏感的方法。     

足和踝关节异常的MRI表现

本简述了ＭＲＩ技术在足和踝关节疾病如骨折与有关并发症、韧带与肌腱损伤、骨和软组织的炎性与感染性疾病、骨和软组织的肿瘤与肿瘤样病变等评价方面的应用。     

获得性免疫缺陷综合征的神经系统影像学表现

获得性免疫缺陷综合征 (ａｃｑｕｉｒｅｄｉｍｍｕｎｏｄｅｆｉｃｉｅｎｃｙｓｙｎ ｄｒｏｍｅ,ＡＩＤＳ)是指以持续性加重的细胞免疫缺陷为基础 ,发生条件致病菌感染、Ｋａｐｏｓｉ’ｓ肉瘤的一组综合征。ＡＩＤＳ常累及中枢神经系统 (ＣＮＳ) ,发病初期即有神经系统功能障碍者占10 % ,整个病程中出现神经系统受累者占 3 9%～ 65 % ,而尸检发现ＣＮＳ受累率高达 73 %～ 90 %。ＡＩＤＳ累及神经系统的影像学检查方法主要是ＣＴ和ＭＲＩ[1～ 3] 。1　历史　　 1981年美国洛杉矶市首次报告了 2例以往健康的同性恋者患卡氏肺囊虫肺炎 ,美国疾病…     

AIDS脑部病变影像学表现分析

目的总结AIDS脑部病变影像学表现,为AIDS脑部病变的影像诊断提供依据。方法回顾性分析19例神经系统型AIDS患者脑部CT和MRI表现。结果5例HIV脑炎中,3例表现为双侧大脑半球白质区对称性异常信号,2例表现为脑萎缩。2例弓形体脑炎影像学表现为基底节区和额顶叶多发密度或/和信号异常,增强T1WI呈多发环状高信号。3例脑淋巴瘤分别表现为双侧大脑半球单发或多发结节,周围伴水肿,增强T1WI呈结节状或不均匀强化。3例脑梗塞表现为基底节区局限性低密度影。2例进行性多灶性白质脑病表现为额顶叶脑白质区多发斑片状异常信号。1例霉菌感染表现为脑干信号异常,增强T1WI呈环状强化;1例霉菌性脑膜炎和2例单纯颅内压增高患者,影像学无异常表现。结论CT和MRI检查可以发现大部分AIDS脑部病变,并可根据影像学表现和其它相关检查做出定性诊断。     

获得性肝性脑部变性的MRI诊断（附7例报告）

获得性肝性脑部变性（acquired hepatocerebral degeneration，AHCD）是慢性肝病引起的一种不可逆的锥体外系综合征，常见于慢性活动性肝炎，酒精性肝硬化及肝移植术后的患者。MR／能有效发现该病的颅内病理改变，本文报道一组经我院临床和MR／诊断为AHCD患者的脑部MRI表现，结合其临床特征，分析AHCD的MRI表现，探讨MRI对该病的诊断价值。     

艾滋病相关性颅内新型隐球菌感染的MRI诊断

目的:探讨艾滋病合并颅内新型隐球菌感染的MRI表现.方法:回顾分析经病原学证实的9例艾滋病合并颅内新型隐球菌感染的MRI表现.结果:根据颅内新型隐球菌感染MRI表现及病理机制,将艾滋病合并颅内新型隐球菌感染分为4型:Ⅰ脑膜脑炎型(1例),Ⅱ类梗死型(1例),Ⅲ梗死型(6例),Ⅳ肉芽肿型(1例).结论:艾滋病合并颅内新型...     

Progressive multifocal leukoencephalopathy in AIDS: initial and follow-up CT and MRI

We sought to determine the value of follow-up CT and MRI in patients with acquired immunodeficiency syndrome (AIDS) and progressive multifocal leukoencephalopathy (PML). We reviewed 50 CT and 19 MRI examinations performed in 21 biopsy- or autopsy-proven cases of PML; 17 patients had follow-up examinations (mean time 5.9 weeks). The radiological examinations were correlated with pathological findings at autopsy. On initial imaging studies, 73 lesions were found. On follow-up, the most striking feature was rapid progression in both size and number of the lesions (from a mean of 3.2 to 6.9 per patient). One third of the patients showed increasing mass effect. A central area suggesting necrosis, of variable size, was found in 12/16 patients. Autopsy revealed macroscopic necrotic changes in the lesions in 11/16 patients. Received: 30 May 1996 Accepted: 14 October 1996     

High-signal lesions in the midbrain on T1-weighted MRI in an HIV-infected patient

In addition to opportunistic infections, neoplasms or cerebrovascular complications, metabolic encephalopathies are a classical cause of diffuse brain dysfunction in HIV infection and are frequent in the terminal stage. We report an HIV-infected patient with symmetrical, focally increased signal in the midbrain on proton density- and T1-weighted MRI without corresponding high signal on T2-weighted images or on CT. While the precise nature and cause of this uncommon finding is not fully understood, the available evidence suggests that these lesions might represent a novel metabolic encephalopathy. Received: 15 December 1995 Accepted: 26 March 1996     

肝豆状核变性的脑部MRI表现：附13例报告

分析１３例肝豆状核变性（ＨＬＤ）脑部ＭＲＩ表现特点以及脑部病变分布和病程间的关系。病程０．１７至９．０年，分为１年内组（７例）和１年后组（６例）、１３例ＨＬＤ壳核全部受累，其次为尾状核（８５％）、丘脑（７７％）、红核（６９％）、苍白球（３１％）、导水管周围灰质（２３％），桥脑（２３％）和黑质（１５％）。其分布特点为双侧对称性，ＭＲＩ多呈长Ｔ１和长Ｔ２信号。壳核病变表现特殊，其外缘呈更长Ｔ１和更长Ｔ     

Primary central nervous system lymphoma in AIDS: a wider spectrum of CT and MRI findings

Diagnosis of primary central nervous system lymphoma (PCNSL) in patients with AIDS based on radiological findings is still a challenging problem. Our purpose was to review the CT and MRI findings in PCNSL in our patients with AIDS and compare them with those reported in the literature. CT and MRI of 28 patients with AIDS and pathologically confirmed PCNSL were analysed retrospectively for the number of lesions, their site, size, density, signal intensity, contrast enhancement, oedema and mass effect. We found 82 lesions. On CT 45 lesions were found in 22 patients, whereas MRI revealed 66 in 20 patients. The lymphoma was solitary in 20 patients (29 %) and multiple in 20 (71 %). Spontaneous haemorrhage was seen in 7 patients. Contrast-enhanced MRI showed no enhancement in 27.3 % (18/66) of the lesions. In one patient diffuse signal abnormalities in the white matter were seen on T2-weighted images. Our findings suggest that the previously described spectrum imaging characteristics of PCNSL has widened. Neuroradiologists should be aware of the variable appearance in patients with AIDS. Spontaneous haemorrhage, a nonenhancing lesion, or diffuse white matter changes do not exclude lymphoma in an immunocompromised patient. Received: 25 January 2000/Accepted: 12 July 2000     

MRI in human immunodeficiency virus-associated cerebral vasculitis

Cerebral ischaemia caused by inflammatory vasculopathies has been described as complication of human immunodeficiency virus (HIV) infection. Imaging studies have shown ischaemic lesions and changes of the vascular lumen, but did not allow demonstration of abnormalities within the vessel wall itself. Two HIV-infected men presented with symptoms of a transient ischaemic attack. Initial MRI of the first showed no infarct; in the second two small lacunar lesions were detected. In both cases, multiplanar 3-mm slice contrast-enhanced T1-weighted images showed aneurysmal dilatation, with thickening and contrast enhancement of the wall of the internal carotid and middle cerebral (MCA) arteries. These findings were interpreted as indicating cerebral vasculitis. In the first patient the vasculopathy progressed to carotid artery occlusion, and he developed an infarct in the MCA territory, but then remained neurologically stable. In the second patient varicella zoster virus (VZV) infection was the probable cause of vasculitis. The clinical deficits and vasculitic MRI changes regressed with antiviral and immunosuppressive therapy. Received: 7 August 1999 Accepted: 3 September 1999     

肝豆状核变性脑部MRI表现（附9例报告）

目的：分析ＨＬＤ脑部ＭＲＩ征象及其与临床间的关系，材料与方法：对９例临床及化验证实的ＨＬＤ患者进行头部ＭＲＩ检查。结果，（１）发病部位依次为苍白球（７７．８％）红核（６６．７％）黑质（６６．７％），导水管周围灰质（６６．７％），壳核（５５．６％），丘脑（５５．６％），脑桥（３３．３％），（２）ＭＲＩ主要表现为继发于铜沉积所致的长Ｔ１长Ｔ２信号，短Ｔ２信号出现机率减少，（３）病程愈长，累及部位愈多，     

Cryptococcus meningoencephalitis in AIDS: parenchymal and meningeal forms

CT and MRI in one case of Cryptococcus neoformans infection showed contrast-enhancing parenchymal lesions resembling granulomata or abscesses. After an initial phase without contrast enhancement, the full extent of the lesions was visible within 2 weeks of presentation. The enhancing masses were assumed to represent intracerebral cryptococcomas. Despite evidence of massive meningeal infection on cerebrospinal fluid (CSF) examination, no radiological signs of meningitis, invasion of the Virchow-Robin spaces or ventriculitis could be demonstrated. With antimycotic treatment the contrast enhancement disappeared and cystic, partly calcified lesions remained. Recurrence of meningeal infection without radiological correlates was apparent in this stage. In a second case of proven cryptococcus meningitis, dilation of Virchow-Robin spaces or cysts in the adjacent parenchyma were the main abnormalities on MRI. Enhancing masses were not detected. These cases may represent two different reactions of the immunocompromised hosts to infection with C. neoformans: widening of the perivascular spaces as a correlate of the more typical meningeal infection and enhancing parenchymal lesions as a sign of further invasion from the CSF spaces. Enhancement of cryptococcomas, indicating an inflammatory response in the surrounding brain, is not typical in patients with impairment of immune function. Received: 11 March 1998 Accepted: 19 June 1998     

艾滋病合并颈髓弓形虫感染的MRI表现(附3例报道)

目的：探讨艾滋病合并脊髓弓形体感染的影像表现。方法：回顾性分析3例艾滋病合并脊髓弓形体感染的影像表现,3例均经MRI颈髓平扫及增强检查,其中1例行头部及胸部MRI平扫及增强检查。结果：1例多部位,多发,2例仅颈髓单发,2例弓形虫抗体（IgA、IgG）检测阳性,1例弓形虫抗体（IgA）检测阴性,弓形虫抗体（IgG）阳性;2例治疗后复查病灶明显缩小,1例病灶消失;MRI平扫脊髓增粗肿胀,病灶呈短T1、短T2信号,周围水肿呈长带状长T1、长T2信号;增强扫描,病灶呈环状、螺旋状或靶形增强。结论：艾滋病患者脑、脊髓内多部位,多病灶,MRI增强呈环状、螺旋状或结节状增强,高度提示脑脊髓感染,影像表现具有特征性,但无特异性。MRI对脑脊髓弓形虫感染是有效的诊断方法。     

MRI在脑干血管母细胞瘤的诊断价值

目的:分析脑干血管母细胞瘤的MRI表现特点,讨论MRI诊断价值及鉴别诊断。材料和方法:经手术和病理证实7例,其中男性2例,女性5例,年龄19~45岁,平均28.7岁;均经MRI平扫及增强扫描。结果:7例脑干血管母细胞瘤1例位于延髓,2例位于延髓与脑桥交界处,4例位于脑桥。6例为单发囊性,呈大囊小结节,囊液呈长T1长T2信号,瘤结节呈不规则形,T1WI为稍低或等信号强度,T2WI呈较高信号强度。瘤旁无水肿或水肿较轻。增强扫描瘤结节明显强化,部分囊壁呈环形强化。1例为实质性,T1WI呈中等偏低信号,T2WI呈中等偏高信号,增强扫描肿瘤显著增强。肿瘤实质内及肿瘤旁可见迂曲的血管流空影。结论:MRI对脑干血管母细胞瘤的诊断具有较高的准确性,尤其是增强扫描对定性诊断及鉴别诊断具有重要价值。