CAJ | 학술논문

目的分析不同临床类型神经梅毒的MRI表现.方法回顾性研究26例神经梅毒患者的临床及MRI资料,描述各种临床类型神经梅毒的MRI表现.结果 26例神经梅毒患者中,17例MRI有异常表现.其中脑膜血管型梅毒7例,主要表现为脑部多发的缺血灶、梗死灶,少数表现为脑炎样改变;麻痹性痴呆6例,主要表现为额、颞叶萎缩,少数伴有脑缺血灶、颗粒性室管膜炎及海马硬化;脊髓膜血管梅毒3例,主要表现为下颈段至下胸段脊髓轻度肿胀,其内可见多发的缺血灶;脊髓痨1例,其脑部MRI表现为缺血灶.9例患者MRI表现正常,其中脑膜型梅毒4例,脊髓痨5例.结论不同临床类型神经梅毒的MRI表现具有一定特征,但缺乏特异性,临床上容易误诊.
목적 분석불동림상류형신경매독적MRI표현.방법 회고성연구26례신경매독환자적림상급MRI자료,묘술각충림상류형신경매독적MRI표현.결과 26례신경매독환자중,17례MRI유이상표현.기중뇌막혈관형매독7례,주요표현위뇌부다발적결혈조、경사조,소수표현위뇌염양개변;마비성치태6례,주요표현위액、섭협위축,소수반유뇌결혈조、과립성실관막염급해마경화;척수막혈관매독3례,주요표현위하경단지하흉단척수경도종창,기내가견다발적결혈조;척수로1례,기뇌부MRI표현위결혈조.9례환자MRI표현정상,기중뇌막형매독4례,척수로5례.결론 불동림상류형신경매독적MRI표현구유일정특정,단결핍특이성,림상상용역오진.
Objective To analyses the magnetic resonance imaging(MRI)findings of different clinical patterns of neurosyphilis(NS).Methods Clinical records and MRI of 26 patients with NS were retrospectively studied.Results Abnormal MRI was found in 17 patients of 26 patients with NS.In 7 patients were with meningo-vascular syphilis,the MRI commonly showed multiple cerebral ischemia focus and cerebral infarction focus,very few similar to those of encephalitis;Six patients had general paresis,who presented cerebral MRI abnormalities of frontal and temporal atrophy,and few simultaneously with cerebral ischemia focus,granular apendymitis and hippocampus sclerosis;Three patients had syphilitic myelitis,their MRI showed mild tumefaction with multiple ischemic focus all the way through lower cervical spinal cord to lower thoracic spinal cord:One patient was with tabes dorsalis,whose cerebral MRI showed ischemic locus.Another 9 patients had normal MRI,of whom 4 patients with meningitis NS and 5 with tabes dorsalis.Conclusion The MRI of neurosyphilis has diverse presentations,and clinicians should pay much attention to it.