早发型先天性梅毒的影像学特点

目的探讨影像学检查对早发型先天性梅毒的诊断价值。方法回顾性分析43例梅毒血清学诊断阳性的早发型先天性梅毒患儿的临床资料和影像资料。结果43例患儿中,男25例,女18例,病变累及多系统、多脏器,其中最常见的为皮肤损害,有29例(67.4%)。43例患儿均有影像学改变,以四肢长骨为主,受累部位多对称,包括股骨42例(97.7%),胫腓骨39例(90.7%),肱骨16例(37.2%),尺桡骨15例(34.9%)。本组患儿的骨骼损害表现以干骺端炎为主35例(81.4%)],其中表现为典型“夹心饼”征者24例(55.8%)、Wimberger征11例(25.6%),骨膜炎23例(53.5%),骨髓炎8例(18.6%)。结论早期先天性梅毒患儿影像学表现典型,影像学检查可辅助临床早期诊断疾病,从而改善预后。计算机断层扫描(CT)检查与磁共振成像(MRI)检查比X线检查更敏感、清晰、直观。

The imaging features of early-onset congenital syphilis

Objective To evaluate the value of imaging in diagnosing early congenital syphilis.Methods The clinical and imaging data of children with serum tests positive for early congenital syphilis were retrospectively analyzed.Results Out of 43 children,24 males and 19 females were included in the study.The clinical lesions involved multiple systems and organs,with skin lesions29 cases(67.4%)]being the most common.All forty-three children had imaging changes,mainly involving the long bones of the limbs,and the affected parts were mostly symmetrical,including 42 cases(97.7%)involving in the femur,39 cases(90.7%)in the tibia and fibula,16 cases(37.2%)of the humerus,15 cases(34.9%)in radius and ulna.The main manifestation of bone damage was metaphysitis in 35 cases(81.4%),including 24 cases(55.8%)revealing typical"sandwich cake"sign,11 cases(25.6%)with Wimberger sign,23 cases(53.5%)with periostitis,and 8 cases of osteomyelitis(18.6%).Conclusion Children with early congenital syphilis have typical imaging findings,and imaging can assist early clinical diagnosis thereby improving prognosis.Computed tomography(CT)and magnetic resonance imaging(MRI)are more sensitive,clear and intuitive than X-rays.