Conventional MRI for diagnosis of subacute combined degeneration (SCD) of the spinal cord due to vitamin B-12 deficiency

脊髓亚急性联合变性的常规 MRI诊断价值分析

Cui-Ping Xiao ； Cui-Ping Ren ； Jing-Liang Cheng ； Yong Zhang ； Ying Li ； Bei-bei Li ； Yi-Zhe Fan

《Asia Pacific Journal of Clinical Nutrition》 25卷1期 (2016/01) Pp. 34-38

https://doi.org/10.6133/apjcn.2016.25.1.04

摘要

脊髓亚急性联合变性（SCD）常发生于维生素B-12缺乏的患者，T2加权像上通常显示为脊髓后索及侧索的异常高信号。本文研究目的在于评估常规磁共振检查对诊断SCD的价值。回顾性分析经临床确诊的SCD患者36例，所有患者均行脊柱MRI扫描，其中8例行增强MRI扫描。36例患者中19例表现为T2加权图像上异常信号，灵敏度为52.8％，其中18例病变位于脊髓后份，1例病变发生于胸髓前份。所有MRI表现异常的患者中，12例异常信号位于颈髓（33.3%），7例病变位于胸髓（19.4%）。颈髓出现异常信号者5例，在轴位T2加权像上呈对称线性高信号，即“倒V”字征，是SCD的典型影像学表现。胸段脊髓异常信号在T2加权像上呈对称性“望远镜”样高信号。8例增强MRI检查的患者仅有1例病变表现出轻度强化。所有36例患者在适当补充维生素B-12治疗后临床症状得到改善。2例MRI随访见异常信号范围较前缩小。因此，传统的MRI检查对诊断及评估维生素B-12缺乏引起的亚急性脊髓联合变性具有价值。

關鍵字

常规磁共振 ； 脊髓亚急性联合变性 ； 维生素B-12 ； 缺乏 ； 营养

並列摘要

Subacute combined degeneration of the spinal cord (SCD) is often found in vitamin B-12 deficiency and typically shows hyperintensity on T2-weighted images of the lateral and posterior columns. The purpose of the study was to evaluate the use of conventional magnetic resonance examination in diagnosing SCD. Thirty-six patients were clinically confirmed and retrospectively analyzed; conventional spine MRIs were available for all patients and eight of them had contrast enhancement MRIs. 19 out of 36 patients showed abnormal signal intensity on T2 weighted images with a sensitivity of 52.8%, among which 18 in the posterior aspect of the spinal cord and 1 in the anterior horn of the thoracic spinal cord The spinal cord abnormalities were seen at the cervical spine in 12 patients (33.3%) and at the thoracic spine in the other 7 patients (19.4%). Axial T2-weighted images showed symmetric linear T2-hyperintensity as an “inverted V” at the cervical spinal cord in 5 patients, which has been reported as a typical sign of SCD. For patients with thoracic spinal cord abnormalities, the bilateral paired nodular T2-hyperintensity looked like “binoculars” at the thoracic spinal cord. Only one out of the eight patients showed slight enhancement after injection with contrast agent. All the 36 patients reported clinical improvement after appropriate vitamin B-12 treatment. The two follow-up spine MRIs showed a decreased extent of the lesion. Therefore, conventional MRI is useful in the diagnosis and management of SCD caused by vitamin B-12 deficiency.

並列關鍵字

conventional magnetic resonance imaging ； subacute combined degeneration of the spinal cord ； vitamin B-12 ； deficiency ； nutrition