NEW POSSIBILITIES OF MAGNETIC RESONANCE IMAGING IN THE DIAGNOSIS OF

NEUROSYPHILIS

 

Dreval M.V., Lagoda O.V., Aslanova G.Kh., Mazur A.S., Krotenkova M.V., Tanashyan M.M.

 

Research Center of Neurology. Moscow, Russia.

S

yphilitic meningovasculitis is the most common form of neurosyphilis, which can potentially lead to arterial thrombosis and cerebral infarction.

Purpose. To demonstrate the difficulties of diagnosing delayed damage to the nervous system in syphilis and the possibilities of new neuroimaging modalities for the diagnosis of secondary CNS vasculitis.

Materials and methods. The article presents a clinical case of a patient with meningoencephalitis in the absence of clear clinical manifestations of syphilis (signs of rashes on the skin and mucous membranes), who had a gradual progression of clinical symptoms over 1.5 years, and the use of MRI of the vascular wall played an important role in identifying the pathological process, determining inflammatory changes in the arteries, making a diagnosis and evaluating the effectiveness of treatment.

Results and discussion. Neuroimaging is of paramount importance for detecting changes in the brain and spinal cord in both the early and late stages of syphilis, and a relatively new method of vascular wall MRI using high spatial resolution sequences and suppressing the signal from moving blood (T1_db_fs) is a useful addition for the differential diagnosis of cerebral vasculitis and intracranial atherosclerosis.

Conclusion. The presented case demonstrates the difficulties of diagnosing late forms of syphilitic lesions of the central nervous system. The possibilities of modern neuroimaging techniques, such as MRI of the vascular wall, are presented not only in detecting inflammatory changes in the arteries, but also in monitoring the condition of cerebral vessels, soft meninges and cistern segments of cranial nerves in dynamics, which provides an assessment of the treatment effectiveness.

 

Keywords: neurosyphilis, vessel wall MRI, syphilitic meningovasculitis.

 

Corresponding author: Mazur A.S., е-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

 

For citation: Dreval M.V., Lagoda O.V., Aslanova G.Kh., Mazur A.S., Krotenkova M.V., Tanashyan M.M. New possibilities of magnetic resonance imaging in the diagnosis of neurosyphilis. REJR 2025; 15(3):247-259. DOI: 10.21569/2222-7415-2025-15-3-247-259.

Received: 23.05.25                 Accepted: 30.10.25