MR imaging of neurosyphilis (report of 2 cases) / 中华放射学杂志

ABSTRACT

Objective To enhance the understanding of MR imaging in neurosyphilis Methods One case of syphilitic gumma with positive treponemal antibody test in the serum was confirmed pathologically after operation, and the other case with positive treponemal antibody test in the cerebrospinal fluid (CBF) was cured by medical therapy Both patients were examined by MRI Results Syphilitic gumma has some characteristic MRI findings The roundish areas of low signal or mixed low and iso signal intensity were revealed on T 1WI with the diameter ranged from 2 0 cm to 2 5 cm The lesions were located at the cortex or infra cortex surrounded by obvious edema The lesions showed high signal or mixed signal made up of iso , high, and low signals on T 2WI Gd DTPA enhanced T 1WI demonstrated irregular circular enhancement on the edge of the lesions and abnormal neighboring meningeal enhancement, and the border of the lesions was angulated with neighboring meninges by obtuse angle Conclusion The final diagnosis of neurosyphilis should depend on laboratory examination or histopathologic examination, but neuroimaging suspicion is paramount to early detection and diagnosis of neurosyphilis