神经梅毒的MRI特点及SPECT脑灌注成像的表现三例

MR Imaging Features and SPECT Perfusion Imaging Findings of Neurosyphilis(report of 3 cases)

目的提高对神经梅毒的MRI特点的认识,并探讨SPECT脑灌注成像技术在神经梅毒的诊断和治疗中的作用。资料与方法回顾性分析确诊的3例神经梅毒患者的有关临床资料,包括头颅MRI和SPECT脑灌注成像的资料。结果3例患者的头颅MRI表现各有特点:1例患者表现为右顶叶占位病变,另2例患者主要表现为脑实质多发性斑点状缺血性改变,其中麻痹性痴呆患者伴有脑萎缩。SPECT检查3例患者的脑血流,都表现出局部脑血流降低。结论头颅MRI是神经梅毒患者影像学检查首选技术,对血清学复发和治疗后随访的神经梅毒患者可进行SPECT脑血流检查。

Objective To improve the understanding of MRI in neurosyphilis, and discuss the role of SPECT perfusion imaging in the diagnosis and treatment of neurosyphilis. Materials and Methods Clinical data, the findings of MRI and SPECT perfusion imaging of 3 cases with definite neurosyphilis were analyzed retrospectively. Results Their MR] mani- festations were different, mass lesion of the right parietal lobe was seen in 1 case, multiple mottling isehemic lesions in cere- bral parenchyma was seen in 2 cases, cerebral atrophy was manifested in patient with general ,paresis of insane. SPECT showed that 3 patients＇local cerebral blood flow was decreased. Conclusion The MRI is the first choice imaging modality to patients with neurosyphilis. The perfusion SPECT imaging can be used to syphilis patients with serological relapse and neurosyphilis patients＇follow up after treatment.