摘要
目的分析不同类型神经梅毒患者的临床表现及磁共振表现。方法对许昌市立医院及南阳市中心医院21例神经梅毒进行回顾性分析。结果 21例神经梅毒患者磁共振表现均有异常;脑实质型神经梅毒17例,磁共振表现双侧颞叶萎缩,颞叶、额叶、岛叶、枕叶多发异常信号,弥散加权成像(DWI)未见明显弥散受限。脑膜血管型2例,1例脑内多发急性期梗死伴基底动脉狭窄,1例脑内多发急性期梗死。梅毒树胶肿2例,磁共振表现颅内多发结节样强化伴邻近脑膜强化。结论神经梅毒的磁共振表现多种多样,虽然缺乏特异性,但可以提示临床医生在类似情况下考虑到神经梅毒,从而进行血清学检测,有助于早期诊断、早期治疗。
Objective To analyze the clinical manifestations of different types of neurosyphilis and their MRI demonstrations.Method A retrospective analysis of 21 cases of neurosyphilis admitted in Xuchang Municipal Hospital and Nanyang Central Hospital was conducted.Results All the 21 cases of neurosyphilis was demonstrated with abnormalities by MRI.There were 17 cases of brain parenchymal type,2 cases of meningeal vascular type,and 2 cases of gumma type.The 17 cases of brain parenchymal type were demonstrated with bilateral temporal lobe atrophy,multiple abnormal signals in the temporal lobe,frontal lobe,insular lobe,and occipital lobe.No obvious diffusion restriction was found by diffusion weighted imaging(DWI).The 2 cases of meningeal vascular type were demonstrated with multiple acute infarction with basilar artery stenosis in one case and multiple acute infarction in the other.The 2 cases of gumma type were demonstrated by MRI with intracranial multiple nodular enhancement with adjacent meningeal enhancement.Conclusion The MRI demonstrations of neurosyphilis are diversified.Although no specific MRI demonstrations is found,they can suggest neurosyphilis when similar demonstrations are radiologically found.Therefore,serological tests can be further ordered for early diagnosis and intervention.
作者
秦转丽
梁新明
樊延龙
潘高争
傅懋林
QIN Zhuan-li;LIANG Xin-ming;FAN Yan-long;PAN Gao-zheng;FU Mao-lin(Department of Radiology,Xuchang Municipal Hospital of Henan Province,Henan Xuchang 461000,China;Department of Neurology,Nanyang Central Hospital,Henan Nanyang 473000,China;Department of Neurology,No.180 Hospital,Fujian Quanzhou 362000,China)
出处
《新发传染病电子杂志》
2018年第1期21-24,共4页
Electronic Journal of Emerging Infectious Diseases
基金
军区医学科技创新项目(15MS111)
