Neurosyphilis MRI
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]
Overview
Spinal and brain MRI may be helpful in the diagnosis of tabes dorsalis. Findings on MRI suggestive of tabes dorsalis include longitudinal T2-weighted hyperintensity in the dorsal columns of the spinal cord, narrowing between the cervical intervertebral discs and partial ankylosis of the cervical disc space, bilateral high intensity signals on the T2 weighted sequence located in mesiotemporal, insular, frontal regions, calcification of the ligamentum flavum.
MRI
Spinal and brain MRI may be helpful in the diagnosis of tabes dorsalis. Findings on MRI suggestive of tabes dorsalis include:
- Longitudinal T2-weighted hyperintensity in the dorsal columns of the spinal cord[1][2]
- Narrowing between the cervical intervertebral discs and partial ankylosis of the cervical disc space[3]
- Bilateral high intensity signals on the T2 weighted sequence located in mesiotemporal, insular, frontal regions[4]
- Calcification of the ligamentum flavum[3]
Overview
MRI scan is not diagnostic of syphilis. However, non-specific MRI findings may demonstrate complications of syphilis including neurological, gastrointestinal, and bone findings.[5][6][7][8][9][10][11][12][13][14][15][16]
MRI
MRI scan is not diagnostic of syphilis. However, non-specific MRI findings may demonstrate complications of syphilis including neurological, gastrointestinal, and bone findings:[5][6][7][8][9][10][11][12][13][14][15]
Neurosyphilis
MRI may help diagnose complications of syphilis such as neurosyphilis. High intensity T2 MRI brain and spinal cord may indicate the following findings:[5][6][7][8][13]
- Non specific white matter lesions (cerebral gummas or arteritis)[6]
- Hyperintensity in mesiotemporal lobes[8][9]
- Cortical atrophy (general paresis)[5]
- Cerebral infarction
- Hippocampal atrophy (mimicking alzheimer's disease)[7]
- Hyperintensities in multiple cortical areas and thalami [11]
- Intramedullary hyperintensity and spinal cord atrophy[16]
Bone
Skull
- T2W lesions in the skull showing hyperintensity[14]
Rectal
- T2W MRI images showing hyperintense thickening of rectal wall (mimicking rectal cancer)[15]
References
- ↑ Bou-Haidar P, Peduto AJ, Karunaratne N (2009). "Differential diagnosis of T2 hyperintense spinal cord lesions: part B." J Med Imaging Radiat Oncol. 53 (2): 152–9. doi:10.1111/j.1754-9485.2009.02067.x. PMID 19527360.
- ↑ Sen A, Chandrasekhar K (2013). "Spinal MR imaging in Vitamin B12 deficiency: Case series; differential diagnosis of symmetrical posterior spinal cord lesions". Ann Indian Acad Neurol. 16 (2): 255–8. doi:10.4103/0972-2327.112487. PMC 3724087. PMID 23956577.
- ↑ 3.0 3.1 Salem KM, Majeed H, Bommireddy R, Klezl Z (2013). "Tertiary syphilis in the cervical spine: a case report and review of the literature". Global Spine J. 3 (1): 41–6. doi:10.1055/s-0032-1329887. PMC 3854603. PMID 24436850.
- ↑ Brisset M, Chadenat ML, Cordoliani Y, Kamga-Tallom R, D'Anglejean J, Pico F (2011). "[MRI features of neurosyphilis]". Rev Neurol (Paris). 167 (4): 337–42. doi:10.1016/j.neurol.2010.08.012. PMID 21440277.
- ↑ 5.0 5.1 5.2 5.3 Peng F, Hu X, Zhong X, Wei Q, Jiang Y, Bao J; et al. (2008). "CT and MR findings in HIV-negative neurosyphilis". Eur J Radiol. 66 (1): 1–6. doi:10.1016/j.ejrad.2007.05.018. PMID 17628376.
- ↑ 6.0 6.1 6.2 6.3 Brightbill TC, Ihmeidan IH, Post MJ, Berger JR, Katz DA (1995). "Neurosyphilis in HIV-positive and HIV-negative patients: neuroimaging findings". AJNR Am J Neuroradiol. 16 (4): 703–11. PMID 7611026.
- ↑ 7.0 7.1 7.2 7.3 Mehrabian S, Raycheva M, Traykova M, Stankova T, Penev L, Grigorova O; et al. (2012). "Neurosyphilis with dementia and bilateral hippocampal atrophy on brain magnetic resonance imaging". BMC Neurol. 12: 96. doi:10.1186/1471-2377-12-96. PMC 3517431. PMID 22994551.
- ↑ 8.0 8.1 8.2 8.3 Jeong YM, Hwang HY, Kim HS (2009). "MRI of neurosyphilis presenting as mesiotemporal abnormalities: a case report". Korean J Radiol. 10 (3): 310–2. doi:10.3348/kjr.2009.10.3.310. PMC 2672188. PMID 19412521.
- ↑ 9.0 9.1 9.2 Szilak I, Marty F, Helft J, Soeiro R (2001). "Neurosyphilis presenting as herpes simplex encephalitis". Clin Infect Dis. 32 (7): 1108–9. doi:10.1086/319598. PMID 11264042.
- ↑ 10.0 10.1 Bash S, Hathout GM, Cohen S (2001). "Mesiotemporal T2-weighted hyperintensity: neurosyphilis mimicking herpes encephalitis". AJNR Am J Neuroradiol. 22 (2): 314–6. PMID 11156776.
- ↑ 11.0 11.1 11.2 Agayeva N, Karli-Oguz K, Saka E (2013). "Teaching NeuroImages: a neurosyphilis case presenting with atypical neuroradiologic findings". Neurology. 80 (11): e119. doi:10.1212/WNL.0b013e318287280b. PMID 23479472.
- ↑ 12.0 12.1 Khamaysi Z, Bergman R, Telman G, Goldsher D (2014). "Clinical and imaging findings in patients with neurosyphilis: a study of a cohort and review of the literature". Int J Dermatol. 53 (7): 812–9. doi:10.1111/ijd.12095. PMID 24261864.
- ↑ 13.0 13.1 13.2 Pandey S (2011). "Magnetic resonance imaging of the spinal cord in a man with tabes dorsalis". J Spinal Cord Med. 34 (6): 609–11. doi:10.1179/2045772311Y.0000000041. PMC 3237288. PMID 22330117 : 22330117 Check
|pmid=value (help). - ↑ 14.0 14.1 14.2 Huang I, Leach JL, Fichtenbaum CJ, Narayan RK (2007). "Osteomyelitis of the skull in early-acquired syphilis: evaluation by MR imaging and CT". AJNR Am J Neuroradiol. 28 (2): 307–8. PMID 17297001.
- ↑ 15.0 15.1 15.2 Cha JM, Choi SI, Lee JI (2010). "Rectal syphilis mimicking rectal cancer". Yonsei Med J. 51 (2): 276–8. doi:10.3349/ymj.2010.51.2.276. PMC 2824876. PMID 20191023.
- ↑ 16.0 16.1 Pandey S (2011). "Magnetic resonance imaging of the spinal cord in a man with tabes dorsalis". J Spinal Cord Med. 34 (6): 609–11. doi:10.1179/2045772311Y.0000000041. PMC 3237288. PMID 22330117 : 22330117 Check
|pmid=value (help). - ↑ Naraghi AM, Salonen DC, Bloom JA, Becker EJ (2010). "Magnetic resonance imaging features of osseous manifestations of early acquired syphilis". Skeletal Radiol. 39 (3): 305–9. doi:10.1007/s00256-009-0806-7. PMID 19795120.