Abstract: Objective To analyze MRI manifestations of meningovascular neurosyphilis,so as to improve its early diagnosis by combination of clinical examinations and laboratory tests. Methods MRI data of 9 patients with meningovascular neurosyphilis were enrolled,with all patients were negative in HIV test.Except for 1 patient who underwent MRI head plain scan,the others were all examined by MRA. Results 7/9 patients were male.The disease started in an acute or subacute way and the main clinical manifestations were paresis,headache,lalopathy,cognitive disorder or any combination of them.The MRI manifestations of meningovascular neurosyphilis included:(1)cerebral atrophy, which could be symmetrical or asymmetrical.(2)cerebral infarction,which could be of multiple locations, and multiple lesions,with varied focal ranges and onset times;(3)cerebrovascular stenosis,which could be of multi-segmental stenosis with bilateral asymmetry,and the proximal part of the arteries was vulnerable to be involved. Conclusion MRA is able to evaluate the cerebral vascular involvement non-invasively.Once a young patient without high risky factors of stroke is manifested as cerebral atrophy,infarction and intracranial vascular stenosis in MRI and MRA,tests of syphilis antibody in serum and cerebrospinal fluid should be carried out as soon as possible,so as to improve the prognosis.

Key words: Neurosyphilis, Meningovascular neurosyphilis, Magnetic resonance imaging