FundamentaÃÃo histopatolÃgica das AlteraÃÃes de imagem por ressonÃncia MagnÃtica das lesÃes no sistema nervoso Central de pacientes com sÃndrome de ImunodeficiÃncia adquirida e Neurotoxoplasmose

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

Objectives : to fundamentate histologically the most important MRI findings in the neurotoxoplasmosis. Patients and Methods : twenty patients with AIDS and neurological signs and symptoms underwent MRI scan (1.0 and 1.5T). We utilized the presuntive clinical, radiological and therapeutic diagnostic criteria. We did MR images in differents orthogonals plans, before and after the contrast media. The exams were valuated in relation to presence of the focal lesion and its number and location. The type of the lesion enhance after the Gadolinium, the presence of the exccentric target sign, the hyperintense areas on T1 in the lesions and the spectroscopy patterns of these lesions. We selected 2 among 23 archive histopathological cases a based on similarity of the macro and microscopy representation in relation to MRI findings of the disease. The histopathological diagnostic criteria was the presence of the toxoplasma cysts. Results : the comparative analyses of the histopathological characteristics of the neurotoxoplasmosis lesions with the MRI findings, allowed to do the fundamentation of the lesions components. On T1-weighted images, the central zone (coagulative necrosis) shown hypointense signal, on T2-weighted images the lesions had variable sign. After the Gadolinium injection, the lesion shown enhance that could be peripheral or diffuse. This area called intermediate zone. Sometimes occured haemorrhage. The peripheral zone represented edema and shown on T1-weighted images hypointense and on T2-weighted images hyperintense sign. We observed the projection of the hyperemic halo into the necrosis area that corresponded to intermediate zone. This detail represented the exccentric target seen on MRI postcontrast, and was called in this work peninsula sign. Conclusion : The descriptive analyses of the MRI findings to confront with histopathological fundaments, possibilited to sugest a lesional pattern to represent neurotoxoplasmosis lesions, allowing of this way, the better diagnostic accuracy

ASSUNTO(S)

imagem por ressonÃncia magnÃtica anatomia patologica e patologia clinica sida resonance magnetic imaging sÃndrome da imunodeficiÃncia adquirida acquired immunodeficiency syndrome histologia toxoplasmose cerebral histology toxoplasmosis, cerebral

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