MRA在神经梅毒不同临床分型中的应用价值

目的探讨磁共振血管成像(MRA)在神经梅毒不同临床分型中的应用价值.方法收集本院治疗前完成MRA检查的神经梅毒患者105例,回顾性分析其影像学表现,根据临床分型统计MRA检查阳性率,并进行对比分析.结果105例神经梅毒患者根据临床分型,脑膜血管型23例,脑膜炎型21例,实质型35例,无症状型25例,树胶肿型1例.MRA检查总阳性44例,阴性61例.MRA表现为大中动脉型25例,其中累及大脑中动脉18例;小动脉型11例及混合型8例.临床各型MRA检查结果比较差异有统计学意义(P<0.001).其中脑膜血管型、脑实质型MRA检查阳性率高于总检查阳性率,差异有统计学意义(P<0.05);脑膜炎型检查阳性率与总检查阳性率比较,差异无统计学意义(P>0.05);无症状型检查阳性率低于总检查阳性率,差异有统计学意义(P<0.001).结论MRA检查在神经梅毒不同临床分型中的应用有所差异,对于脑膜血管型和实质型应用价值更高.

Objective To investigate the application value of magnetic resonance angiography(MRA)in different clinical types of neurosyphilis.Methods 105 neurosyphilis patients who completed MRA examination in our hospital before treatment were included in this study,and their imaging manifestations were retrospectively analyzed.The positive rate of MRA examination was statistically analyzed according to clinical classification,and a comparative analysis was made.Results According to the clinical classification of 105 neurosyphilis patients,meningeal vascular type(n=23),21 cases were meningitis type(n=21),parenchyma type(n=35),asymptomatic type(n=25)and gumma type(n=1)were found.The positive in 44 cases(41.9%)and negative in 61 cases(58.1%)were showed in MRA examination.Large and medium artery type in 25 cases(involving middle cerebral artery in 18 cases),arteriolar type in 11 cases and mixed type in 8 cases were manifested.There were significant differences among positive rate of MRA in different types of neurosyphilis(P<0.001).The MRA positive rate of meningeal vascular type and brain parenchyma type were significantly higher than that of total MRA(P<0.05).The MRA positive rate of meningitis type was lower than that of total MRA,and there was no statistical difference(P>0.05).The MRA positive rate of asymptomatic type was significantly lower than that of total MRA,and there was statistical difference(P<0.001).Conclusion The application value of MRA in different clinical types of neurosyphilis patients are different,among which the meningeal vascular type and parenchymal type have more application value.