分享

神经医学影像论坛邀您来诊断(三)答案

 zskyteacher 2017-11-27


History:  HIV-positive woman with severe headache, nausea, vomiting, and fever.

(HIV阳性妇女伴有严重头痛、恶心、呕吐和发烧。)

正确答案:弓形虫病

Toxoplasmosis of the CNS

Toxoplasmosis is the most common opportunistic CNS infection in patient's with AIDS (about 10% of AIDS patient's will develop this infection). The routes of transmission include ingestion of the tachyzoites (ingestion of uncooked meats) or oocysts (ingestion of feces-contaminated food), transplacental, transfusions, and organ transplants.  More than 50% of the adult population in the US have antibodies to Toxoplasma.  Acute toxoplasmosis in an immunocompromised patient usually occurs through the reactivation of a latent infection.  The most common areas affected within the brain include the basal ganglia and the cortical medullary junctions. These lesions are usually associated with a moderate amount of edema and mass effect.(弓形虫病是艾滋病患者最常见的机会性中枢神经系统感染(约有10%的艾滋病患者会感染这种疾病)。传播途径包括弓形虫速殖子(未煮熟的肉类摄入)或卵囊(粪便污染的食物的摄入)、胎盘、输血、器官移植。美国成年人口中有超过50%的人有弓形虫抗体。免疫低下患者的急性弓形虫通常是通过潜伏感染再次发生。大脑内最常见的区域包括基底节区和皮髓交界区。这些病变通常伴有中度水肿和占位效应。)

Toxoplasmosis lesions tend to occur in the   basal ganglia and cortical medullary junctions.Toxoplasmosis on a CT scan typically appears as a single or multiple ring-enhancing lesions with a moderate amount of peripheral edema.

 On T1-weighted images, the lesions are hypointense relative to graymatter.   On T2-weighted images , the lesions are hyperintense ,or occasionally isointense to hypointense. Surrounding edema is usually seen. Nodular or ring enhancement can be seen in approximately 70% of patients following intravenous injection of gadolinium.(弓形体病往往发生在基底节和皮髓交界区,CT上弓形虫通常表现为单个或多个环形强化病变,并伴有中等程度的周围水肿。T1加权像病灶相对于灰质呈低信号。在T2加权像呈高信号或偶尔呈中等偏低信号,通常可见周围水肿。静脉注射钆剂后约70%的患者可见结节状或环状强化。)

 

    本站是提供个人知识管理的网络存储空间,所有内容均由用户发布,不代表本站观点。请注意甄别内容中的联系方式、诱导购买等信息,谨防诈骗。如发现有害或侵权内容,请点击一键举报。
    转藏 分享 献花(0

    0条评论

    发表

    请遵守用户 评论公约

    类似文章 更多