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Case Reports
. 2021 Feb;55(1):48-51.
doi: 10.1007/s13139-021-00684-9. Epub 2021 Feb 6.

Imaging Characteristics of Brain SPECT, PET, and MRI in Neurosyphilis

Eun Kyoung Choi  1 , Young Do Kim  2 , Hyeonseok Jeong  1   3 , Yong-An Chung  1   3 , Jin Kyoung Oh  1 , In-Uk Song  2
Affiliations
Case Reports

Imaging Characteristics of Brain SPECT, PET, and MRI in Neurosyphilis

Eun Kyoung Choi et al. Nucl Med Mol Imaging. 2021 Feb.

Abstract

The incidence of neurosyphilis has declined since effective penicillin therapy against Treponema pallidum was introduced. However, the diagnosis of neurosyphilis early in the disease course is very important in order to select appropriate antibiotic therapy. We report brain MRI, SPECT with Tc-99m ECD, and PET with F-18 FDG findings before antibiotic therapy in a neurosyphilis patient with neurological symptoms. The cerebral cortices showed hypoperfusion with a patchy distribution on SPECT and foci with high signal intensity on MRI, suggesting ischemia. Brain PET showed areas with hypometabolism in the temporoparietal lobes bilaterally.

Keywords: Magnetic resonance imaging; Neurosyphilis; Positron-emission tomography; Tomography, emission-computed, single-photon.

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Conflict of interest statement

Conflict of InterestEun Kyoung Choi, Young Do Kim, Hyeonseok Jeong, Yong-An Chung, Jin Kyoung Oh, and In-Uk Song declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
a T2-weighted MRI and fluid attenuated inversion recovery (FLAIR) images revealed multiple high signal intensity foci (arrowheads) in the cerebral white matter. b Brain SPECT showed multifocal hypoperfusion with a patchy distribution throughout the cerebral cortices. c Brain PET showed hypometabolism in temporoparietal cortex and thalamus bilaterally
Fig. 2
Fig. 2
Follow-up SPECT showed improvement of cerebral perfusion
See this image and copyright information in PMC

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