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Neuroimaging findings of cerebral syphilitic gumma

  • Authors:
    • Cao Li
    • Shi‑Jie Wang
    • Guang‑Cai Tang
    • Luo‑Tong Liu
    • Guang‑Xiang Chen
  • View Affiliations / Copyright

    Affiliations: Department of Radiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China, Department of Ultrasonography, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China, Department of Neurosurgery, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, P.R. China
    Copyright: © Li et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 4185-4192
    |
    Published online on: October 8, 2019
       https://doi.org/10.3892/etm.2019.8089
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Abstract

Cerebral syphilitic gumma is a rarely reported disease of the central nervous system. Magnetic resonance imaging (MRI) is an important diagnostic method for syphilitic gumma. The present study aimed to describe and characterize neuroimaging results from 6 patients with pathologically diagnosed cerebral syphilitic gumma. The 6 patients (age, 32‑61 years) underwent brain CT and MRI, with 1 patient also undergoing whole‑body 2‑deoxy‑2‑(fluorine‑18)fluoro‑D‑glucose‑positron emission tomography/CT (18F‑FDG PET/CT). Non‑enhanced CT, conventional T1 weighted imaging (T1WI) and T2WI, diffusion weighted imaging (DWI) and gadolinium‑enhanced T1WI images were acquired for all patients. The CT and MRI scans were retrospectively reviewed by two experienced radiologists for consensus on the location, number, size, T1WI, T2WI and DWI signal intensity characteristics, extent of vasogenic oedema, and enhancement patterns. In total, the 6 patients exhibited 10 lesions, nine of which were located in the cerebral hemisphere, primarily in the grey matter. The remaining lesion was located in the fourth ventricle, leading to mild‑to‑moderate hydrocephalus. The diameters of the identified 10 lesions ranged from 0.9‑6.5 cm, with a mean diameter of 3.9 cm. The main feature observed in CT was low density and in MRI the features were T1WI and DWI hypointensity and T2WI hyperintensity. A single case exhibited syphilis gumma with massive haemorrhage. Ring‑like or strip‑like signs (n=5), accompanied by the dural tail sign (n=2) and homogeneous enhancement (n=1), were noted on T1WI with gadolinium. The 18F‑FDG PET/CT performed in one patient of a cerebral syphilis gumma revealed low uptake and metabolism. The present study indicated that gadolinium‑enhanced MRI combined with 18F‑FDG PET/CT and laboratory examinations are helpful in distinguishing cerebral syphilitic gumma from brain tumors and infectious diseases, therefore avoiding unnecessary surgery.
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Copy and paste a formatted citation
Spandidos Publications style
Li C, Wang SJ, Tang GC, Liu LT and Chen GX: Neuroimaging findings of cerebral syphilitic gumma. Exp Ther Med 18: 4185-4192, 2019.
APA
Li, C., Wang, S., Tang, G., Liu, L., & Chen, G. (2019). Neuroimaging findings of cerebral syphilitic gumma. Experimental and Therapeutic Medicine, 18, 4185-4192. https://doi.org/10.3892/etm.2019.8089
MLA
Li, C., Wang, S., Tang, G., Liu, L., Chen, G."Neuroimaging findings of cerebral syphilitic gumma". Experimental and Therapeutic Medicine 18.6 (2019): 4185-4192.
Chicago
Li, C., Wang, S., Tang, G., Liu, L., Chen, G."Neuroimaging findings of cerebral syphilitic gumma". Experimental and Therapeutic Medicine 18, no. 6 (2019): 4185-4192. https://doi.org/10.3892/etm.2019.8089
Copy and paste a formatted citation
x
Spandidos Publications style
Li C, Wang SJ, Tang GC, Liu LT and Chen GX: Neuroimaging findings of cerebral syphilitic gumma. Exp Ther Med 18: 4185-4192, 2019.
APA
Li, C., Wang, S., Tang, G., Liu, L., & Chen, G. (2019). Neuroimaging findings of cerebral syphilitic gumma. Experimental and Therapeutic Medicine, 18, 4185-4192. https://doi.org/10.3892/etm.2019.8089
MLA
Li, C., Wang, S., Tang, G., Liu, L., Chen, G."Neuroimaging findings of cerebral syphilitic gumma". Experimental and Therapeutic Medicine 18.6 (2019): 4185-4192.
Chicago
Li, C., Wang, S., Tang, G., Liu, L., Chen, G."Neuroimaging findings of cerebral syphilitic gumma". Experimental and Therapeutic Medicine 18, no. 6 (2019): 4185-4192. https://doi.org/10.3892/etm.2019.8089
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