梅毒是一种由梅毒螺旋体引起的传染病,苍白球亚种。尽管在广泛使用青霉素后,其发病率有所下降,它最近又重新出现了,尤其是与男性发生性关系的男性和患有人类免疫缺陷病毒(HIV)的人。梅毒的神经系统表现,通常被称为神经梅毒,可能出现在感染期间的任何时间,包括初次感染后的最初几年。神经梅毒可以无症状,只有脑脊液异常,或症状,以几种不同的临床综合征为特征,比如脑膜炎,gumma,脑膜血管,脑实质受累,脑膜脊髓炎,tabesdorsalis,和周围神经系统受累。然而,这些综合症可能会模拟其他几种疾病,诊断往往是一个挑战。此外,梅毒也可以在怀孕期间从母婴垂直传播,导致神经系统表现。神经影像学检查对于显示神经梅毒患者的异常脑或脊髓表现至关重要。帮助诊断,治疗,并对这些患者进行随访。本文旨在综述神经梅毒的影像学特点,包括感染的早期和晚期。
Syphilis is an infectious disease caused by the spirochete Treponema pallidum, subspecies pallidum. Although its incidence has declined after the widespread availability of penicillin, it has recently re-emerged, especially in men who have sex with men and in people living with human immunodeficiency virus (HIV). The neurological manifestations of syphilis, generally known as neurosyphilis, may appear at any time during the infection, including the initial years after the primary infection. Neurosyphilis can be asymptomatic, only with cerebrospinal fluid abnormalities, or symptomatic, characterized by several different clinical syndromes, such as meningitis,
gumma, meningovascular, brain parenchyma involvement, meningomyelitis, tabes dorsalis, and peripheral nervous system involvement. However, these syndromes may simulate several other diseases, making the diagnosis often a challenge. In addition, syphilis can also be vertically transmitted from mother to child during pregnancy, leading to neurological manifestations. Neuroimaging is essential to demonstrate abnormal brain or spinal cord findings in patients with neurosyphilis, aiding in the diagnosis, treatment, and follow-up of these patients. This article aims to review the imaging features of neurosyphilis, including the early and late stages of the infection.