脊髓亚急性联合变性的MRI影像学特征

目的 评价MRI在脊髓亚急性联合变性(SCD)诊断中的重要价值. 资料与方法 收集经临床确诊的24例SCD患者的MRI资料,所有患者均于确诊前接受脊柱MRI检查,其中5例行增强检查,4例于治疗后复查.分析影像学特点. 结果 24例SCD中18例出现髓内异常信号,阳性率为75%.主要位于颈胸段脊髓后索(12例)或侧索并后索(5例),呈对称性等或稍长T1、长T2信号;1例同时累及后索、侧索、前索和部分灰质后角;脊髓无明显肿胀;增强后有(2/5)或无强化效应(3/5);治疗后4例病变范围均显示减小,甚至消失. 结论 SCD具有一定特征性的MRI影像表现,MRI在早期诊断及观察疗效上具有重要价值.

The MRI Characteristics of Subacute Combined Degeneration of the Spinal Cord

Objective To evaluate the diagnosis value of MRI in spinal cord subacute combined degeneration (SCD) . Materials and Methods The MR images were collected and retrospectively analyzed in 24 SCD patients.All the patients underwent MR scan before clinical diagnosis.Five of them accepted enhanced MR scan and four undertaken the follow-up MR scan after Vitamin B12 treatment. Results Among the 24 patients of SCD, 18 cases showed abnormal MR findings.Positive rate were 75%.The abnormal findings of these patients included: symmetrical intramedullary lesions located in posterior column (12 cases) or both posterior and lateral column(5 cases) of thoracic and cervical vertebral.In addition, one case located in posterior column,lateral column, anterior column and partly gray matter.All the lesions showed iso or slightly long T1 and long T2 signal intensity without spinal cord swelling.After administration of contrast agent, the lesions had mild patchy enhancement (2/5) or not(3/5) .The 4 lesions diminished or disappeared on the follow-up MR images. Conclusion SCD has specific MR characteristics.MR plays an important role in diagnosing and evaluating the therapeutic effect of SCD.