Syphilis MRI: Difference between revisions

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==MRI==
==MRI==
Longitudinal T2W hyperintensity in the dorsal columns of the spinal cord.
MRI scan is not diagnostic of syphilis. However, non-specific MRI findings may demonstrate complications of syphilis including pulmonary, cardiac, neurological, gastrointestinal, and bone findings:<ref name="pmid17628376">{{cite journal| author=Peng F, Hu X, Zhong X, Wei Q, Jiang Y, Bao J et al.| title=CT and MR findings in HIV-negative neurosyphilis. | journal=Eur J Radiol | year= 2008 | volume= 66 | issue= 1 | pages= 1-6 | pmid=17628376 | doi=10.1016/j.ejrad.2007.05.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17628376  }} </ref><ref name="pmid7611026">{{cite journal| author=Brightbill TC, Ihmeidan IH, Post MJ, Berger JR, Katz DA| title=Neurosyphilis in HIV-positive and HIV-negative patients: neuroimaging findings. | journal=AJNR Am J Neuroradiol | year= 1995 | volume= 16 | issue= 4 | pages= 703-11 | pmid=7611026 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7611026  }} </ref><ref name="pmid22994551">{{cite journal| author=Mehrabian S, Raycheva M, Traykova M, Stankova T, Penev L, Grigorova O et al.| title=Neurosyphilis with dementia and bilateral hippocampal atrophy on brain magnetic resonance imaging. | journal=BMC Neurol | year= 2012 | volume= 12 | issue=  | pages= 96 | pmid=22994551 | doi=10.1186/1471-2377-12-96 | pmc=3517431 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22994551  }} </ref><ref name="pmid19412521">{{cite journal| author=Jeong YM, Hwang HY, Kim HS| title=MRI of neurosyphilis presenting as mesiotemporal abnormalities: a case report. | journal=Korean J Radiol | year= 2009 | volume= 10 | issue= 3 | pages= 310-2 | pmid=19412521 | doi=10.3348/kjr.2009.10.3.310 | pmc=2672188 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19412521  }} </ref><ref name="pmid11264042">{{cite journal| author=Szilak I, Marty F, Helft J, Soeiro R| title=Neurosyphilis presenting as herpes simplex encephalitis. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 7 | pages= 1108-9 | pmid=11264042 | doi=10.1086/319598 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11264042  }} </ref><ref name="pmid11156776">{{cite journal| author=Bash S, Hathout GM, Cohen S| title=Mesiotemporal T2-weighted hyperintensity: neurosyphilis mimicking herpes encephalitis. | journal=AJNR Am J Neuroradiol | year= 2001 | volume= 22 | issue= 2 | pages= 314-6 | pmid=11156776 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11156776  }} </ref><ref name="pmid23479472">{{cite journal| author=Agayeva N, Karli-Oguz K, Saka E| title=Teaching NeuroImages: a neurosyphilis case presenting with atypical neuroradiologic findings. | journal=Neurology | year= 2013 | volume= 80 | issue= 11 | pages= e119 | pmid=23479472 | doi=10.1212/WNL.0b013e318287280b | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23479472  }} </ref><ref name="pmid24261864">{{cite journal| author=Khamaysi Z, Bergman R, Telman G, Goldsher D| title=Clinical and imaging findings in patients with neurosyphilis: a study of a cohort and review of the literature. | journal=Int J Dermatol | year= 2014 | volume= 53 | issue= 7 | pages= 812-9 | pmid=24261864 | doi=10.1111/ijd.12095 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24261864  }} </ref><ref name="pmid:    22330117">{{cite journal| author=Pandey S| title=Magnetic resonance imaging of the spinal cord in a man with tabes dorsalis. | journal=J Spinal Cord Med | year= 2011 | volume= 34 | issue= 6 | pages= 609-11 | pmid=:    22330117 | doi=10.1179/2045772311Y.0000000041 | pmc=3237288 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22330117  }} </ref><ref name="pmid17297001">{{cite journal| author=Huang I, Leach JL, Fichtenbaum CJ, Narayan RK| title=Osteomyelitis of the skull in early-acquired syphilis: evaluation by MR imaging and CT. | journal=AJNR Am J Neuroradiol | year= 2007 | volume= 28 | issue= 2 | pages= 307-8 | pmid=17297001 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17297001  }} </ref><ref name="pmid20191023">{{cite journal| author=Cha JM, Choi SI, Lee JI| title=Rectal syphilis mimicking rectal cancer. | journal=Yonsei Med J | year= 2010 | volume= 51 | issue= 2 | pages= 276-8 | pmid=20191023 | doi=10.3349/ymj.2010.51.2.276 | pmc=2824876 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20191023  }} </ref>
===Neurosyphilis===
MRI may help diagnose complications of syphilis such as neurosyphilis. High intensity T2 MRI brain and spinal cord may indicate the following findings:<ref name="pmid17628376">{{cite journal| author=Peng F, Hu X, Zhong X, Wei Q, Jiang Y, Bao J et al.| title=CT and MR findings in HIV-negative neurosyphilis. | journal=Eur J Radiol | year= 2008 | volume= 66 | issue= 1 | pages= 1-6 | pmid=17628376 | doi=10.1016/j.ejrad.2007.05.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17628376  }} </ref><ref name="pmid7611026">{{cite journal| author=Brightbill TC, Ihmeidan IH, Post MJ, Berger JR, Katz DA| title=Neurosyphilis in HIV-positive and HIV-negative patients: neuroimaging findings. | journal=AJNR Am J Neuroradiol | year= 1995 | volume= 16 | issue= 4 | pages= 703-11 | pmid=7611026 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7611026  }} </ref><ref name="pmid22994551">{{cite journal| author=Mehrabian S, Raycheva M, Traykova M, Stankova T, Penev L, Grigorova O et al.| title=Neurosyphilis with dementia and bilateral hippocampal atrophy on brain magnetic resonance imaging. | journal=BMC Neurol | year= 2012 | volume= 12 | issue=  | pages= 96 | pmid=22994551 | doi=10.1186/1471-2377-12-96 | pmc=3517431 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22994551  }} </ref><ref name="pmid19412521">{{cite journal| author=Jeong YM, Hwang HY, Kim HS| title=MRI of neurosyphilis presenting as mesiotemporal abnormalities: a case report. | journal=Korean J Radiol | year= 2009 | volume= 10 | issue= 3 | pages= 310-2 | pmid=19412521 | doi=10.3348/kjr.2009.10.3.310 | pmc=2672188 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19412521  }} </ref><ref name="pmid:    22330117">{{cite journal| author=Pandey S| title=Magnetic resonance imaging of the spinal cord in a man with tabes dorsalis. | journal=J Spinal Cord Med | year= 2011 | volume= 34 | issue= 6 | pages= 609-11 | pmid=:    22330117 | doi=10.1179/2045772311Y.0000000041 | pmc=3237288 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22330117  }} </ref>   
*Non specific [[white matter]] lesions (cerebral gummas or [[arteritis]])<ref name="pmid7611026">{{cite journal| author=Brightbill TC, Ihmeidan IH, Post MJ, Berger JR, Katz DA| title=Neurosyphilis in HIV-positive and HIV-negative patients: neuroimaging findings. | journal=AJNR Am J Neuroradiol | year= 1995 | volume= 16 | issue= 4 | pages= 703-11 | pmid=7611026 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7611026  }} </ref>
*Hyperintensity in mesiotemporal lobes<ref name="pmid19412521">{{cite journal| author=Jeong YM, Hwang HY, Kim HS| title=MRI of neurosyphilis presenting as mesiotemporal abnormalities: a case report. | journal=Korean J Radiol | year= 2009 | volume= 10 | issue= 3 | pages= 310-2 | pmid=19412521 | doi=10.3348/kjr.2009.10.3.310 | pmc=2672188 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19412521  }} </ref><ref name="pmid11264042">{{cite journal| author=Szilak I, Marty F, Helft J, Soeiro R| title=Neurosyphilis presenting as herpes simplex encephalitis. | journal=Clin Infect Dis | year= 2001 | volume= 32 | issue= 7 | pages= 1108-9 | pmid=11264042 | doi=10.1086/319598 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11264042  }} </ref>
*Cortical atrophy (general paresis)<ref name="pmid17628376">{{cite journal| author=Peng F, Hu X, Zhong X, Wei Q, Jiang Y, Bao J et al.| title=CT and MR findings in HIV-negative neurosyphilis. | journal=Eur J Radiol | year= 2008 | volume= 66 | issue= 1 | pages= 1-6 | pmid=17628376 | doi=10.1016/j.ejrad.2007.05.018 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17628376  }} </ref>
*Cerebral infarction
*Hippocampal atrophy(mimicking alzheimer's disease)<ref name="pmid22994551">{{cite journal| author=Mehrabian S, Raycheva M, Traykova M, Stankova T, Penev L, Grigorova O et al.| title=Neurosyphilis with dementia and bilateral hippocampal atrophy on brain magnetic resonance imaging. | journal=BMC Neurol | year= 2012 | volume= 12 | issue=  | pages= 96 | pmid=22994551 | doi=10.1186/1471-2377-12-96 | pmc=3517431 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22994551  }} </ref>
*Hyperintensities in multiple cortical areas and thalami <ref name="pmid23479472">{{cite journal| author=Agayeva N, Karli-Oguz K, Saka E| title=Teaching NeuroImages: a neurosyphilis case presenting with atypical neuroradiologic findings. | journal=Neurology | year= 2013 | volume= 80 | issue= 11 | pages= e119 | pmid=23479472 | doi=10.1212/WNL.0b013e318287280b | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23479472  }} </ref>
*Intramedullary hyperintensity and cord atrophy<ref name="pmid:22330117">{{cite journal| author=Pandey S| title=Magnetic resonance imaging of the spinal cord in a man with tabes dorsalis. | journal=J Spinal Cord Med | year= 2011 | volume= 34 | issue= 6 | pages= 609-11 | pmid=:    22330117 | doi=10.1179/2045772311Y.0000000041 | pmc=3237288 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22330117  }} </ref>
===Bone===
*Small tibial and fibular nodular<ref name="pmid19795120">{{cite journal| author=Naraghi AM, Salonen DC, Bloom JA, Becker EJ| title=Magnetic resonance imaging features of osseous manifestations of early acquired syphilis. | journal=Skeletal Radiol | year= 2010 | volume= 39 | issue= 3 | pages= 305-9 | pmid=19795120 | doi=10.1007/s00256-009-0806-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19795120  }} </ref>
===Skull===
*T2W lesions in the skull showing hyperintensity<ref name="pmid17297001">{{cite journal| author=Huang I, Leach JL, Fichtenbaum CJ, Narayan RK| title=Osteomyelitis of the skull in early-acquired syphilis: evaluation by MR imaging and CT. | journal=AJNR Am J Neuroradiol | year= 2007 | volume= 28 | issue= 2 | pages= 307-8 | pmid=17297001 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17297001  }} </ref>
===Rectal===
*T2W images showing hyperintense thickening of rectal wall(mimicking rectal cancer)<ref name="pmid20191023">{{cite journal| author=Cha JM, Choi SI, Lee JI| title=Rectal syphilis mimicking rectal cancer. | journal=Yonsei Med J | year= 2010 | volume= 51 | issue= 2 | pages= 276-8 | pmid=20191023 | doi=10.3349/ymj.2010.51.2.276 | pmc=2824876 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20191023  }} </ref>
   
   



Revision as of 19:34, 10 October 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2]

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Overview

MRI

MRI scan is not diagnostic of syphilis. However, non-specific MRI findings may demonstrate complications of syphilis including pulmonary, cardiac, neurological, gastrointestinal, and bone findings:[1][2][3][4][5][6][7][8][9][10][11]

Neurosyphilis

MRI may help diagnose complications of syphilis such as neurosyphilis. High intensity T2 MRI brain and spinal cord may indicate the following findings:[1][2][3][4][9]

  • Non specific white matter lesions (cerebral gummas or arteritis)[2]
  • Hyperintensity in mesiotemporal lobes[4][5]
  • Cortical atrophy (general paresis)[1]
  • Cerebral infarction
  • Hippocampal atrophy(mimicking alzheimer's disease)[3]
  • Hyperintensities in multiple cortical areas and thalami [7]
  • Intramedullary hyperintensity and cord atrophy[12]

Bone

  • Small tibial and fibular nodular[13]

Skull

  • T2W lesions in the skull showing hyperintensity[10]

Rectal

  • T2W images showing hyperintense thickening of rectal wall(mimicking rectal cancer)[11]


References

  1. 1.0 1.1 1.2 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.
  2. 2.0 2.1 2.2 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.
  3. 3.0 3.1 3.2 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.
  4. 4.0 4.1 4.2 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.
  5. 5.0 5.1 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.
  6. 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.
  7. 7.0 7.1 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.
  8. 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.
  9. 9.0 9.1 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).
  10. 10.0 10.1 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.
  11. 11.0 11.1 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.
  12. 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).
  13. 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.


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