Современное состояние проблемы дифференциальной диагностики структурных поражений головного мозга у пациентов со СПИДом по данным МРТ (обзор литературы)
DOI:
https://doi.org/10.21638/11701/spbu11.2018.407Аннотация
В статье представлен актуальный обзор литературы о наиболее распространенных поражениях головного мозга пациентов на фоне СПИДа. Описана типичная картина заболеваний и варианты их проявлений по данным магнитно-резонансной томографии. В деталях рассмотрены особенности радиологических проявлений поражений головного мозга с масс-эффектом: токсоплазмоза, первичной лимфомы ЦНС и нейротуберкулеза. Особенность собранного материала заключается в описание широкого спектра вариантов течения заболеваний, типичных радиологических синдромов и отличительных особенностей, которые лежат в основе дифференциальной диагностики этих состояний. Подробно представлены структурные изменения из группы поражений без масс-эффекта, такие как прогрессирующая мультифокальная лейкоэнцефалопатия и ВИЧ-ассоциированная энцефалопатия. В своей работе мы обращаем внимание на уникальный полиморфизм прогрессирующей мультифокальный лейкоэнцефалопатии, который выражается как различиями в накоплении контрастного вещества, так и вариациями наличия признака масс-эффекта. Представлены данные сравнения диагностической эффективности методик спиральной компьютерной и магнитной резонансной томографии в диагностике СПИД-ассоциированных поражений. Учитывая различия в стандартных протоколах в лечебных учреждениях и потенциально высокую специфичность методики МРТ, мы представили ориентировочный минимально достаточный протокол сканирования головного мозга ВИЧ-инфицированных пациентов, который позволит считать исследование информативным.
Ключевые слова:
магнитно-резонансная томография, ВИЧ, СПИД, головной мозг, оппортунистические инфекции, нейротуберкулез, токсоплазмоз, ПМЛ, лимфома
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Литература
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Опубликован
20.01.2018
Как цитировать
Дроздов, А. А., Черемисин, В. М., Камышанская, И. Г., Яковлев, А. А., Мусатов, В. Б., Федуняк, И. П., … Артемьева, М. Н. (2018). Современное состояние проблемы дифференциальной диагностики структурных поражений головного мозга у пациентов со СПИДом по данным МРТ (обзор литературы). Вестник Санкт-Петербургского университета. Медицина, 13(4), 403–418. https://doi.org/10.21638/11701/spbu11.2018.407
Выпуск
Раздел
Лучевая диагностика, лучевая терапия
Лицензия
Статьи журнала «Вестник Санкт-Петербургского университета. Медицина» находятся в открытом доступе и распространяются в соответствии с условиями Лицензионного Договора с Санкт-Петербургским государственным университетом, который бесплатно предоставляет авторам неограниченное распространение и самостоятельное архивирование.
