28例梅毒患者的颅脑MRI研究
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摘要
目的:探讨28例梅毒患者颅脑MRI改变,以提高对梅毒MRI表现的认识能力。方法:选择东南大学附属南京第二医院于2013年1月至2016年12月收治的梅毒患者28例。应用全身MR扫描仪(Siemens Sonata 1.5T)扫描参数,采用3D LAVA序列动态增强扫描,对比剂为钆喷替酸葡甲胺0.1mmol/kg。且28例患者均检测脑脊液RPR和TPPA。结果:梅毒患者脑脊液RPR和TPPA阳性率均为100.00%。28例梅毒患者MRI检查脑萎缩15例、脑梗死6例、脑炎4例、正常3例。其中,脑萎缩多为显著脑萎缩;脑梗死6例中,额叶皮层下多发腔隙病灶4例,脑干梗死1例;脑炎4例中,病变仅累及双侧海马内颞叶1例,病变累及多个脑叶3例。结论:颅脑MRI检查梅毒患者可以反映颅脑表现,且可以反映病变范围,具有重要临床意义。
Objective: To investigate the change in brain magnetic resonance imaging( MRI) in 28 patients with syphilis,so as to improve the ability to recognize the MRI of syphilis. Methods: 28 patients with syphilis in Nanjing Second Hospital Affiliated to Southeast University from January 2013 to December 2016 were enrolled. The parameters of the model were simulated by 3 D LAVA,and the contrast agent was gadolinium acid and 0. 1 mmol/kg. The 28 patients were examined for cerebrospinal fluid RPR and TPPA. Results: The positive rates of RPR and TPPA in cerebrospinal fluid of patients with syphilis were 100. 00%. Among the 28 patients examined by MRI,there were 15 cases of cerebral atrophy,6 cases of cerebral infarction,4 cases of encephalitis and 3 normal cases.Among the 6 cases of cerebral infarction,there were 4 cases of cerebral fissure and a case of brain stem infarction;among the 4 cases of encephalitis,the lesion only involved in bilateral hippocampus temporal lobe in a case,and lesions involved multiple lobes in 3 cases. Conclusions: MRI examination of syphilis can reflect the brain manifestation and the scope of the disease,which has important clinical significance.
Objective: To investigate the change in brain magnetic resonance imaging( MRI) in 28 patients with syphilis,so as to improve the ability to recognize the MRI of syphilis. Methods: 28 patients with syphilis in Nanjing Second Hospital Affiliated to Southeast University from January 2013 to December 2016 were enrolled. The parameters of the model were simulated by 3 D LAVA,and the contrast agent was gadolinium acid and 0. 1 mmol/kg. The 28 patients were examined for cerebrospinal fluid RPR and TPPA. Results: The positive rates of RPR and TPPA in cerebrospinal fluid of patients with syphilis were 100. 00%. Among the 28 patients examined by MRI,there were 15 cases of cerebral atrophy,6 cases of cerebral infarction,4 cases of encephalitis and 3 normal cases.Among the 6 cases of cerebral infarction,there were 4 cases of cerebral fissure and a case of brain stem infarction;among the 4 cases of encephalitis,the lesion only involved in bilateral hippocampus temporal lobe in a case,and lesions involved multiple lobes in 3 cases. Conclusions: MRI examination of syphilis can reflect the brain manifestation and the scope of the disease,which has important clinical significance.
引文
[1]Sethi S,Sharma K,Dhaliwal L K,et al.Declining trends in syphilis prevalence among antenatal women in northern India:A 10-year analysis from a tertiary healthcare centre.Sexually Transmitted Infections,2017,83(7):592-592.
[2]申智蒙,韩聪,甘信涛,等.神经梅毒树胶肿影像学误诊为恶性脑膜瘤1例.中国实验诊断学,2015,13(7):1203-1204.
[3]Moradi A,Salek S,Daniel E,et al.Clinical features and incidence rates of ocular complications in patients with ocular syphilis.American Journal of Ophthalmology,2015,159(2):334-343.
[4]黄成锋,卢常盛,黄丹丹.神经梅毒患者41例临床特征分析.中国临床研究,2015,28(5):627-629.
[5]李梅,徐全刚,王均清,等.核磁共振成像显示视神经蛛网膜下腔增宽的病因分析.中华眼科杂志,2016,52(12):911-917.
[6]陈勇,顾红岩,张玲,等.117例神经梅毒临床流行病学特征分析.中国艾滋病性病,2015,24(10):879-883.
[7]汤海燕,谈鹰.脑血管型神经梅毒的临床及影像学特点.实用医学杂志,2016,32(9):1494-1496.
[8]Benzaken AS,SabidóM,Galban EG,et al.Field evaluation of the performance and testing costs of a rapid point-of-care test for syphilis in a red-light district of Manaus,Brazil.Sexually Transmitted Infections,2017,84(4):297-302.
[9]程勇,曹敬荣,王培昌.抗-HIV阴性神经梅毒患者的临床特点与实验室检测分析.中华实验和临床感染病杂志(电子版),2016,10(6):669-673.
[10]叶林峰,吴小杨,林齐防,等.麻痹性痴呆患者海马磁共振波谱研究.临床神经病学杂志,2015,28(6):456-459.
[11]李莉,李宏军,任美吉,等.AIDS与非AIDS患者神经梅毒影像表现对比分析.首都医科大学学报,2016,37(4):460-464.
[12]鞠贵平,庄志清.以精神障碍为首发症状的神经梅毒15例临床分析.中国实用神经疾病杂志,2010,13(23):21-22.
[13]SidibéM,Singh P K.Thailand eliminates mother-to-child transmission of HIV and syphilis.Lancet,2016,387(10037):2488-2489.
[14]Abate M,Wolde T.Seroprevalence of Human Immunodeficiency Virus,Hepatitis B Virus,Hepatitis C Virus,and Syphilis among Blood Donors at Jigjiga Blood Bank,Eastern Ethiopia.Ethiopian Journal of Health Sciences,2016,26(2):153-160.
[15]徐晖,刘奎伟.梅毒患者的颅脑MRI表现.临床放射学杂志,2015,34(5):831-832.
[16]周婧,李南云,周晓军,等.神经梅毒的临床病理分析.临床与实验病理学杂志,2016,32(12):1404-1407.
[17]王丽,唐芳,白琛,等.梅毒患者的颅脑MRI表现研究].中国性科学,2017,26(1):55-57.
[18]魏琳,沈桂权,曹笑婉,等.神经梅毒的临床表型与MRI表现.实用放射学杂志,2016,32(5):674-677.
[2]申智蒙,韩聪,甘信涛,等.神经梅毒树胶肿影像学误诊为恶性脑膜瘤1例.中国实验诊断学,2015,13(7):1203-1204.
[3]Moradi A,Salek S,Daniel E,et al.Clinical features and incidence rates of ocular complications in patients with ocular syphilis.American Journal of Ophthalmology,2015,159(2):334-343.
[4]黄成锋,卢常盛,黄丹丹.神经梅毒患者41例临床特征分析.中国临床研究,2015,28(5):627-629.
[5]李梅,徐全刚,王均清,等.核磁共振成像显示视神经蛛网膜下腔增宽的病因分析.中华眼科杂志,2016,52(12):911-917.
[6]陈勇,顾红岩,张玲,等.117例神经梅毒临床流行病学特征分析.中国艾滋病性病,2015,24(10):879-883.
[7]汤海燕,谈鹰.脑血管型神经梅毒的临床及影像学特点.实用医学杂志,2016,32(9):1494-1496.
[8]Benzaken AS,SabidóM,Galban EG,et al.Field evaluation of the performance and testing costs of a rapid point-of-care test for syphilis in a red-light district of Manaus,Brazil.Sexually Transmitted Infections,2017,84(4):297-302.
[9]程勇,曹敬荣,王培昌.抗-HIV阴性神经梅毒患者的临床特点与实验室检测分析.中华实验和临床感染病杂志(电子版),2016,10(6):669-673.
[10]叶林峰,吴小杨,林齐防,等.麻痹性痴呆患者海马磁共振波谱研究.临床神经病学杂志,2015,28(6):456-459.
[11]李莉,李宏军,任美吉,等.AIDS与非AIDS患者神经梅毒影像表现对比分析.首都医科大学学报,2016,37(4):460-464.
[12]鞠贵平,庄志清.以精神障碍为首发症状的神经梅毒15例临床分析.中国实用神经疾病杂志,2010,13(23):21-22.
[13]SidibéM,Singh P K.Thailand eliminates mother-to-child transmission of HIV and syphilis.Lancet,2016,387(10037):2488-2489.
[14]Abate M,Wolde T.Seroprevalence of Human Immunodeficiency Virus,Hepatitis B Virus,Hepatitis C Virus,and Syphilis among Blood Donors at Jigjiga Blood Bank,Eastern Ethiopia.Ethiopian Journal of Health Sciences,2016,26(2):153-160.
[15]徐晖,刘奎伟.梅毒患者的颅脑MRI表现.临床放射学杂志,2015,34(5):831-832.
[16]周婧,李南云,周晓军,等.神经梅毒的临床病理分析.临床与实验病理学杂志,2016,32(12):1404-1407.
[17]王丽,唐芳,白琛,等.梅毒患者的颅脑MRI表现研究].中国性科学,2017,26(1):55-57.
[18]魏琳,沈桂权,曹笑婉,等.神经梅毒的临床表型与MRI表现.实用放射学杂志,2016,32(5):674-677.