Objective To evaluate CT features of pulmonary tuberculosis in the patients with HIV infection and AIDS(HIV/AIDS).Methods CT findings of pulmonary tuberculosis were retrospectively analyzed in 48 patients with HIV/AIDS.Results The CT features of pulmonary tuberculosis in HIV/AIDS included: secondary pulmonary tuberculosis in 19 cases(39.6%), mostly showing patchings shadows,10 cases with large confluent consolidation; hematogenous pulmonary tuberculosis in 17 cases(35.4%), including 7 cases of acute miliary tuberculosis(showing miliary lesions evenly distributed in both lungs), and 10 cases of sub-acute disseminated tuberculosis(showing nodular patterns diffusely distributed in both lungs, asymmetrical in size and distribution); complex lesions in 10 cases(20.8%, showing patchy, nodular and miliary lesions). Among all the patients, 36 (75.0%) showed enlarged mediastinal lymphnodes, 13(27.1%) pleural effussion, 10(20.8%) pericardial effusion.Conclusion The characteristics of pulmonary tuberculosis in the patients with HIV/AIDS were mostly diffuse distribution.

Objective To study the abdominal CT findings of the penicilliesis marneffei in patients with AIDS.Methods Abdominal CT imaging features of the the penicilliesis mameffei in 35 patients with acquired immunodeficiency syndrome (AIDS) were retrospectively analyzed.Results Abdominal lymph adenopathy was observed in 27 (77.1%) cases.Hepatosplenomegaly was observed in 18 (51.4%) cases.Lesions in the liver and spleen were found in 11 (31.4%) cases which included 3 cases of low density nodules in the liver (8.6%) and 5 cases of low density nodules in the spleen (14.3%).5 cases of diffuse low density in the liver (14.3%) and 5 cases of heterogeneous enhancement in the liver (14.3%) .Thickening of the intestinal wall was observed in 3 cases (8.6%). Ascites was observed in 4 cases (11.4%).Pancreatitis was found in 1 case(2.9%).Conclusions Penicilliosis marneffei in patients with AIDS usually involves multiple organs in the abdomen.Abdominal lymphadenopathy, hepatosplenomegaly and parenchymai lesions in the liver and spleen are the most common CT findings in the abdomen.

ObjectiveTo summarize X-ray and CT findings of soft tissue and bone infections secondary to acquired immunodeficiency syndrome (AIDS).MethodsThe data of X-ray and CT findings of soft tissue and bone infections in 18 patients with AIDS were retrospectively collected and analyzed.ResultsOf 18 patients with AIDS,the CT features of soft tissue demonstrated that subcutaneous patchy high density in 1 case which considered as cellulitis,round low density lesions with ring enhancement in 6 cases which considered as soft tissue abscesses,heterogeneous density lesions with peripheral enhancement in 1 case which considered as pyomyositis.Of 18 patients with AIDS,septic arthritis was found in 4 cases involving knee lesion in 3 cases and hip lesion.In the 4 case,the X-ray films showed bony destruction in 2 cases and the CT showed bone destruction in 3 cases and arthroedema in 4 cases.Of 18 patients with AIDS,osteomyelitis was found in 9 cases of which tuberculosis was considered in 8 cases and vertebral involvement in 6 cases.In the 9 cases,the X-ray films and CT displayed bony destruction,hyperostosis,small sequestra,and intervertebral space narrowing.Of 18 patients with AIDS,costal lesions were found in 3 cases in which the CT showed expandable bony destruction.Of 18 patients with AIDS,ilium and cacroihac joint lesions were found in 1 case in which the X-ray films and CT showed bony destruction,sequestra,and joint widening.Of 18 patients with AIDS,chronic pyogenic osteomyelitis of femur was found in 1 case in which the X-ray films showed bony destruction,hyperostosis osteosclerosis,and periosteal reaction.Conclusion The X-ray and CT features of soft tissue and bone infections secondary to AIDS are characterized.The X-ray and CT are useful tools to early diagnose soft tissue and bone infections secondary to AIDS.

Objective To study the CT findings of abdominal tuberculosis in patients with AIDS.Methods CT imaging features of abdominal tuberculosis in 33 patients with AIDS were retrospectively analyzed. Results Abdominal lymph adenopathy were observed in 23 cases (69. 7%, 23/33 ).Hepatosplenomegaly were observed in 10 cases (30. 3%, 10/33). Multiple low density nodes in spleen were observed in 14 cases(42. 4%, 14/33)including 9 cases of diffuse, low density nodes (27. 3% ,9/33). Low density lesions in liver were observed in 7 cases (21.2%, 7/33 ) including a case of tuberculous abscess (3.0%, 1/33 ) . Peritoneum and epiploon involvements were found in 5 cases ( 15.2%, 5/33 ) with associated ascites in 2 cases ( 6. 1%, 2/33 ) . Thickening of intestines wall were observed in 4 cases ( 12. 1% ,4/33). Destruction of lumbar vertebra with cold abscess was observed in 1 case (3.0% ,1/33).Abscess in psoas was observed in 1 case (3.0%, 1/33). Conclusion Abdominal tuberculosis in patients with AIDS usually involves multiple organs in the abdomen. CT has an important role in the detection and following up examination of these lesions.

Objective To evaluate the etiology and CT features of thoracic lymphadenopathy in patients with acquired immunodeficiency syndrome (AIDS).Methods CT features of thoracic lymphadenopathy in 178 AIDS patients were retrospectively analyzed.Results Of 668 AIDS patients with thoracic lymphadenopathy,174 were proved to be infections including Penicilliosis marneffei (n =117),tuberculosis (n =42),cryptococcosis (n =10) and non-tuberculous mycobacteria (n =5).Four were proved to be tumors including 3 Kaposi's sarcomas and 1 lymphoma.The enlarged mediastinal and hilar lymph node presented as homogeneous soft-tissue density in 140 patients,with central low attenuation in 29 patients,as extreme low attenuation in 9 patients on plain CT scan and showed homogeneous enhancement in 28 patients,rim enhancement in 19 patients,non enhancement in 2 patients on enhanced CT scan.Accompanied CT findings included diffuse pulmonary micro-nodules (n =45),primary complex or similar primary complex (n =13),pleural effusion (n =59),pericardial effusion (n =24),sandwich sign in the small bowel mesentery (n =31).The CT findings of penicilliosis marneffei and tuberculosis were compared with chisquare test.There were significant differences on homogeneous soft-tissue density,central low attenuation,homogeneous enhancement,rim enhancement,diffuse pulmonary micro-nodules,primary complex or similar primary complex,sandwich sign,pleural effusion (x2 =32.62,43.82,12.13,15.72,11.76,11.06,5.44,4.07,P ＜ 0.05).Conclusions Thoracic lymphadenopathy can be caused by infections and tumors in AIDS.CT plays an important role for the differential diagnosis.

Objective To determine the results of treatment combining all-trans-retinoic acid(ATRA)in childhood acute promyelocytic leukemia(APL).Methods 22 children with newly diagnosed APL received induction therapy with ATRA followed by 3 courses of consolidation chemotherapy:daunorubicin,idarubicin,homoharringtonine or aclacinomycin plus cytosine arabinoside.A maintenance therapy was then administered with ATRA and these reigems for 36 months.Results Early deaths from diffuse intravazcular clotting and intracranial hemorrhage occurred in two patients.The other children achieved a complete remission(CR).By June 2007,the estimated disease-free survival rates at 1,3 and 5 years were 100%,93.3% and 84.7%;respectively.The side effects of ATRA were xerosis eutis and xerocheilia,headaches,nausea and vomiting,hepatic function lesion and ATRA syndrome.Conclusion Remission induction therapy with ATRA is effective and safe for newly diagnosed childhood APL.The maintenance therapy combined chemotherapy with ATRA can improve the long-term effects of APL patients.The main causes of death in APL children is diffuse intravascular clotting and intracranial hemorrhage.The side effects of ATRA can be tolerated.

OBJECTIVETo study the chest X-ray image features of patients with severe SARS.

METHODSChest X-ray image features in 36 patients with severe SARS were retrospectively analyzed. The image characteristics were compared with those of 224 patients with common SARS.

RESULTSThe important chest X-ray imaging features of 36 patients with severe SARS included small patch of infiltration (n = 27, 75.0%), large patch of infiltration (n = 22, 61.1%), large area of lung consolidation (n = 10, 27.3%), interstitial lung lesion (n = 26, 72.2%), ground-glass shadow (n = 28, 77.8%), irregular linear opacity (n = 15, 41.7%), diffuse lung lesion (n = 12, 33.3%), with single lung involved (n = 9, 25.0%), and both lungs involved (n = 32, 88.9%). The rates of large patch of infiltration, large area of lung consolidation, ground-glass shadow, diffuse lung lesion and involvement of both lungs in patients with severe SARS were significantly higher than those in patients with common type of SARS (all P < 0.01). Out of the 11 severe SARS patients who died, nine had large area of ground-glass shadow with air bronchogram in both lungs before death.

CONCLUSIONSLarge patch of infiltration, large area of consolidation, ground-glass shadow, diffuse lung lesion and involvement of both lungs were the main X-ray image characteristics of patients with severe SARS. Large area of ground-glass shadow with air bronchogram in both lungs indicated a bad prognosis.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Radiography, Thoracic ; Severe Acute Respiratory Syndrome ; diagnostic imaging

Objective To observe the clinical effect of sequential therapy with micafungin and reduced -dose voriconazole in prevention of invasive fungal infections in patients received allogeneic hematopoietic stem cell transplantion (Allo -HSCT).Methods 28 patients received the treatments for prevention of fungal infection with micafungin 50 mg per day from pretreatment to 30 days,then oral voriconazole at a dose of 1 00 mg two times per day until 90 days after Allo -HSCT.The occurrence of invasive fungal infection and the side effects of both medicine were observed during 1 80 days after Allo -HSCT.Results 8 patients(28.6%)developed above grade 2 acute graft verse host disease(GVHD),2 patients developed grade 3 GVHD among the 8 patients.Two case with GVHD were cured by voriconazole with the therapeutic dose who occurred probably pulmonary invasive fungal infection at two months after Allo -HSCT.There were no other patients diagnosed fungal infection.No toxic efect were observed during the clinical observation during treatment with micafungin.5 patients appeared mild liver function abnormalities during treatment with voriconazole,and liver dysfunction were improved by symptomatic treatment.2 cases developed transient auditory hallucination and visual impairment induced by voriconazole.Conclusion Micafungin and reduced -dose voricon-azole are effective and safe prophylaxis in prevention early invasive fungal infection after HSCT.

Objective To study the chest radiographic appearances of the non-tuberculous mycobacterial(NTM) pulmonary infection in patients with acquired immune deficiency syndrome (AIDS).Methods Ten patients with AIDS and NTM underwent chest X-ray radiography and 7 patients performed high-resolution CT (HRCT) scan. Chest radiographic features of NTM in patients with AIDS were retrospectively analyzed. Results The chest radiograph showed bilateral pulmonary involvement in 6 cases and single lung involvement in 4 cases (3 cases in the right, 1 case in the left). Patchy air space consolidation (6 cases), large consolidation (5 cases), cavitation (5 cases), small nodules (3 cases),military nodules (2 cases), linear opacity ( 1 cases) were demonstrated on radiography. On HRCT, air space consolidation (7 cases), small nodules (6 cases), large consolidation (5 cases) with cavitation and cylindric bronchiectasis after the absorption of consolidation, enlarged hilar and mediastinal lymph nodes (4 cases), ground-glass opacities (3 cases), military nodules and "tree-in-bud" sign (2 case), pleural effusion ( 1 case), pericardial effusion ( 1 case) and fibrotic band ( 1 case) were found. Conclusion The most common radiographic appearances of NTM in patients with AIDS are bilateral small nodules, large consolidation with cavitation and cylindric bronchiectasis, enlarged hilar and mediastinal lymph nodes.