神经梅毒临床及影像学特征分析

目的分析神经梅毒的临床特点及影像学（CT或MRI）表现。方法回顾性分析临床与实验室证实的15例神经梅毒患者的有关临床资料。结果15例患者均为男性，年龄24～73岁；表现为无症状（1例）、脑卒中（6例）、精神心理障碍（4例）、脊髓损害（3例）、癫痫发作（1例）。影像学表现：脑血管梅毒为多发梗塞灶，大小不一，累及皮层及皮层下；麻痹性痴呆为弥漫性脑萎缩及脑实质多发散在异常信号；脊髓脑膜血管梅毒为脊髓多节段炎症。结论神经梅毒以脑膜血管梅毒较多，误诊率较高，出现影像学高度怀疑的征象对早期发现及诊断该病具有重要意义。

Clinical and imaging features of neurusyphilis

Objective To analyze the clinical features and neuroimaging （ CT or MRI） manifestations of neurosyphilis. Methods We performed a retrospective analysis of the clinical information of 15 cases of neurosyphilis who had been identified by clinical features and laboratory examinations. Results Fifteen patients were all male, their ages ranged from 24 to 73 years. Clinical presentations included asymptomatic （ 1 case）, stroke （6 cases）, psychiatric disorders （4 cases）, spinal cord damage （3 cases）, and seizure （ 1 case）. CT or MRI showed multiple and different infarctions in cortex and subcortex in patients with cerebral vascular syphilis, wide cerebral atrophy and multiple abnormal signals in cerebral parenchyma in patients with general paresis of insane and inflammation of multi - segments of spinal cord in patients with spinal meningovascular syphilis. Conclusion Meningovascular syphilis is the most common type of neurosyphilis. The misdiagnosis rate of neurosyphilis is high. Neuroimaging findings are valuable for the early diagnosis of neurosyphilis.