脊髓亚急性联合变性的MRI诊断要点分析  

MR imaging features of subacute combined degeneration

作　　者：崔林阳[1] 张晨[1] 张敬[1] 

机构地区：[1]天津医科大学总医院放射科,天津300052

出　　处：《国际医学放射学杂志》2015年第2期103-106,共4页International Journal of Medical Radiology

摘　　要：目的分析脊髓亚急性联合变性(SCD)的MRI诊断要点。资料与方法回顾性分析15例临床确诊SCD的病人临床及MRI资料,分析其脊髓MRI表现特点,统计分析SCD病人受累脊髓节段数与血清VB12水平、发病时间的相关性。结果 15例SCD病人均于横断面影像上显示颈胸段脊髓对称性等或长T1、长T2信号,13例病变主要位于颈胸段水平脊髓后索,2例同时累及后索、侧索及前索。但于横断面T2WI上颈段与胸段脊髓异常信号形态各具特点。颈段脊髓受累时于横断面T2WI上呈脊髓内"倒V"形或"反兔耳"形的对称性高信号。胸段脊髓受累时于横断面T2WI上呈脊髓内"哑铃"形的对称性高信号。统计学分析显示15例SCD病人脊髓受累节段数与血清VB12水平呈负相关,而与病程长短无相关性。结论脊髓MR成像对于SCD脊髓疾病的诊断有重要价值。Objective The study was to analyze spinal MR imaging features of subacute combined degeneration （SCD）, and to evaluate the value of spinal MR imaging in the diagnosis of SCD. Materials and Methods Fifteen patients diagnosed with SCD were comprised, the MRI and clinical data were collected. We retrospective analyzed the MRI manifestations and also discussed the correlations between the involved spinal cord segments and the level of serumal vitamin B12, and onset time in patients with SCD. Results All the 15 patients showed abnormal MR finding. MR images of these patients revealed symmetrical hypointense or isointense signals on T1WI and hyperintense on T2WI in the cervical and thoracic spine. The intramedullary lesions located in the posterior column of the cervical and thoracic spine in 13 patients, in both posterior, lateral and anterior column in 2 patients. However the signals in the cervical and thoracic spine showed different characteristics on the axial T2WI. For patients with cervical spinal cord abnormalities, the lesions showed symmetric T2-hyperintensity as an “inverted V”or “inverted rabbit ears”at cervical spinal cord on axial T2-weighted images. For patients with thoracic spinal cord abnormalities, the lesions showed bilateral paired nodular T 2-hyperintensity as“dumbbell”at thoracic spinal cord. The statistical analysis of these 15 cases of SCD showed that the involved spinal cord segments was negatively correlated with the level of serumal vitamin B12, and had no correlation with course of disease. Conclusion Spinal MRI plays an important role in diagnosing SCD.

关 键 词：脊髓 磁共振成像 亚急性联合变性 维生素B12缺乏 脊髓疾病 

分 类 号：R744.6[医药卫生—神经病学与精神病学]