Abstract: Objective To analyze the clinical manifestations of different types of neurosyphilis and their MRI demonstrations. Method A retrospective analysis of 21 cases of neurosyphilis admitted in Xuchang Municipal Hospital and Nanyang Central Hospital was conducted. Results All the 21 cases of neurosyphilis was demonstrated with abnormalities by MRI. There were 17 cases of brain parenchymal type, 2 cases of meningeal vascular type, and 2 cases of gumma type. The 17 cases of brain parenchymal type were demonstrated with bilateral temporal lobe atrophy, multiple abnormal signals in the temporal lobe, frontal lobe, insular lobe, and occipital lobe. No obvious diffusion restriction was found by diffusion weighted imaging (DWI). The 2 cases of meningeal vascular type were demonstrated with multiple acute infarction with basilar artery stenosis in one case and multiple acute infarction in the other. The 2 cases of gumma type were demonstrated by MRI with intracranial multiple nodular enhancement with adjacent meningeal enhancement. Conclusion The MRI demonstrations of neurosyphilis are diversified. Although no specific MRI demonstrations is found, they can suggest neurosyphilis when similar demonstrations are radiologically found. Therefore, serological tests can be further ordered for early diagnosis and intervention.

Key words: Neurosyphilis, MRI