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Abdominal CT in patients with AIDS

¹ Department of Radiology, The Royal Marsden Hospital, Downs Road, Sutton SM2 5PT and ² Department of Radiology, Chelsea and Westminster Hospital, London SW10 9NH, UK

View larger version (117K): [in a new window]   Figure 1. Mycobacterium tuberculosis (MTB) infection and ascites. 43-year-old man with MTB infection showing multiple retroperitoneal lymph nodes associated with peritoneal nodules. High attenuation ascites are also shown.

View larger version (64K): [in a new window]   Figure 2. Mycobacterium avium-intracellulare (MAI) and Mycobacterium tuberculosis (MTB) lymphadenopathy. (a) In this 36-year-old man with MAI infection, there are discrete lymph nodes of uniform attenuation within the retroperitoneum and small bowel mesentery. (b) In another 38-year-old man with MTB infection, lymph nodes within the retroperitoneum show typical central low attenuation.

View larger version (99K): [in a new window]   Figure 3. Focal splenic lesions. In this 33-year-old man with abdominal Mycobacterium tuberculosis infection there are multiple low attenuation lesions within the spleen. This appearance is, however, non-specific in the patient with AIDS.

View larger version (103K): [in a new window]   Figure 4. Terminal ileitis. In this 44-year-old man with Mycobacterium tuberculosis infection there is concentric thickening of the terminal ileum.

View larger version (121K): [in a new window]   Figure 5. Cytomegalovirus colitis. CT in this 34-year-old with colitis shows concentric thickening of the ascending colon. There is minimal pericolic inflammatory change. Note the absence of significant lymphadenopathy within the retroperitoneum.

View larger version (92K): [in a new window]   Figure 6. Candidiasis. Barium oesophagram in this 26-year-old man with diffuse mucosal irregularity giving rise to a shaggy appearance typical of oesophageal candidiasis.

View larger version (95K): [in a new window]   Figure 7. Pneumocystis carinii. This man with previous pneumocystis infection of the kidneys demonstrates multiple, well defined, punctate calcifications within the renal parenchyma bilaterally.

View larger version (117K): [in a new window]   Figure 8. Cryptosporidiosis. 45-year-old man with microbiologically proven cryptosporidiosis. There are multiple loops of fluid-filled small bowel showing concentric wall thickening.

View larger version (121K): [in a new window]   Figure 9. AIDS cholangiopathy. There is mild dilatation of the intrahepatic ducts on CT in this patient with an enlarged liver. Endoscopic retrograde cholangiopancreatography (not shown) revealed multiple strictures of the intrahepatic ducts, resembling sclerosing cholangitis.

View larger version (132K): [in a new window]   Figure 10. Bacillary angiomatosis. This 36-year-old man demonstrates several low attenuation lesions within the liver and spleen, associated with lymphadenopathy in the retroperitoneum.

View larger version (68K): [in a new window]   11 (a) Pyelonephritis. This patient presented with acute flank pain. Note the striated nephrogram within the slightly enlarged kidneys, typical of acute pyelonephritis. (b) Pancreatitis. In another patient receiving protease inhibitor, there is enlargement and heterogeneity of the head of the pancreas associated with stranding of the peripancreatic fat. The appearance is consistent with acute pancreatitis.

View larger version (91K): [in a new window]   Figure 12. (a) Lymphoma. There are two low attenuation lesions within an enlarged liver. There is no appreciable enhancement of these lesions. (b) CT demonstrates a solitary lesion in a normal-sized spleen. Lymphoma may present as multiple, small, splenic, low attenuation foci, splenic enlargment or a focal solitary lesion, as demonstrated here. (c) There are multiple masses of low attenuation within the kidneys. The appearance is typical of lymphomatous involvement of the kidneys.

View larger version (133K): [in a new window]   Figure 13. Anorectal carcinoma. Post-intravenous gadolinium T1 weighted axial MR image showing an enhancing soft tissue mass arising from the left of the anal canal, breaching the external sphincter.

View larger version (123K): [in a new window]   Figure 14. Urolithiasis. Excretory urogram demonstrating left ureteric obstruction in a patient receiving indinavir. The obstruction spontaneously resolved after 48 h.

View larger version (136K): [in a new window]   Figure 15. Lipodystrophy. In this 38-year-old man receiving protease inhibitor, note the relative paucity of subcutaneous fat compared with the generous intraabdominal fat deposition. The appearance is typical of AIDS-related lipodystrophy.