MRI of the Spinal Cord in Vitamin B12 Deficiency

維他命B12缺乏症其脊髓磁振造影之表現

傅進華(Chin-Hua Fu) ； 陳慧菁(Hui-Ching Chen) ； 曹汶龍(Wen-Long Tsao)

《慈濟醫學雜誌》 16卷3期 (2004/06) Pp. 199-204

https://doi.org/10.6440/TZUCMJ.200406.0199

摘要

缺乏維他命B12常會造成血液及神經學上的病變。脊髓外側及後側神經纖維退化症，便是常見因維他命B12缺乏所引起的疾病，又稱做脊髓亞急性合併退化症 (subacute combined degeneration of the spinal cord)。這篇文章裡我們報告三位這樣的病例，臨床上他們表現出頸椎及胸椎的脊髓病變，檢驗結果呈現出巨紅血球性貧血及缺乏維他命B12，而脊髓磁振造影顯示在脊柱外側及後側有不正常的訊號表現，這與臨床表徵相吻合。因此，在疑似的個案中早期藉由脊髓磁振造影檢查出病兆並及時治療，可以完全改善這樣的病變，以免留下神經學後遺症。報告中的三位病例在確定診斷並積極治療追蹤後，無論在臨床症狀或是影像學上都獲得很大的進步。

關鍵字

亞急性合併退化症 ； 維他命B12 ； 磁振造影 ； 脊髓病變

並列摘要

Vitamin B12 deficiency causes hematological and neurological diseases. Subacute combined degeneration (SCD) of the spinal cord characterized by degeneration of the lateral and posterior columns is often found due to vitamin B12 deficiency. We described three patients with SCD presenting with cervical and thoracic myelopathy. Laboratory data revealed vitamin B12 deficiency and MRI of the spinal cord demonstrated abnormal hyperintense signal changes on T2-weighted imaging involving the posterior and lateral columns. Early recognition of this specific MRI pattern is essential in these patients even before the results of laboratory tests are available to ensure early and prompt treatment at the reversible stage. In our cases, follow-up MRI findings correlated well with clinical outcome after treatment with Vitamin B12 supplements.

並列關鍵字

subacute combined degeneration ； vitamin B12 ； magnetic resonance imaging ； myelopathy