CTICasesActive Syphilitic Aortitis
Imaging findings
CT and MRI of the chest demonstrate marked, concentric wall thickening and significant mural edema of the ascending aorta (best seen on black-blood and STIR sequences), without severe dilatation or calcification, in a patient with acute/subacute tertiary syphilis.
Key takeaways
Active syphilitic aortitis (prior to the development of chronic aneurysmal dilation and calcification) is characterized by intense mural inflammation and edema of the ascending aorta. MRI is superior to CT for demonstrating these active inflammatory changes, which can resolve with penicillin therapy.
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