MRI联合血红蛋白、血清维生素B_(12)对脊髓亚急性联合变性的诊断价值  

Diagnostic value of MRI combined with hemoglobin and blood vitamin B12 examination in subacute combined degeneration of spinal cord

作　　者：王涛[1] 姜世培 吴洋洋 胡晓[3] 王荣品[1] WANG Tao;JIANG Shipei;WU Yangyang;HU Xiao;WANG Rongpin(Department of Imaging in Guizhou Provincial People’s Hospital,Guizhou,55002,China)

机构地区：[1]贵州省人民医院医学影像科/贵州省智能医学影像分析与精准诊断重点实验室/贵州省精准影像诊疗示范型国际科技合作基地,贵州贵阳550002 [2]贵州医科大学第二附属医院放射科,贵州凯里556000 [3]贵州省人民医院神经内科,贵州贵阳550002

出　　处：《中国中西医结合影像学杂志》2023年第2期136-139,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：贵州省科技计划项目(黔科合支撑〔2019〕2810号);国家自然科学基金后补助资金(GPPH-NSFC-2019-28)。

摘　　要：目的:探讨MRI联合血红蛋白及血清维生素B12检查对脊髓亚急性联合变性(SCD)的诊断价值。方法:回顾性分析41例经临床诊断为SCD患者的临床及MRI资料,根据脊髓MRI结果分为A组(MRI阳性)、B组(MRI阴性);统计分析2组血红蛋白水平、血清维生素B12含量及脊髓内MRI异常信号的差异。结果:A组12例,其中8例累及脊髓后索和/或侧索呈典型表现,血红蛋白均值为(109.4±15.2)g/L,血清维生素B12均值为(141.0±39.2)ng/L;4例累及脊髓灰质及后索、侧索呈非典型表现,血红蛋白均值为(115.1±17.5)g/L,血清维生素B12均值为(182.8±101.9)ng/L;12例异常信号范围均超过3个椎体,脊髓形态无明显肿胀。B组29例,血红蛋白均值为(134.7±16.2)g/L,血清维生素B12均值为(199.2±31.4)ng/L。2组血红蛋白水平差异有统计学意义(P<0.05),血清维生素B12水平差异无统计学意义(P>0.05)。结论:SCD的脊髓MRI表现具有一定特异性,血红蛋白水平与影像表现存在一定相关性,熟悉该病MRI表现并结合血红蛋白检查有助于提高对该病的诊断水平。Objective:To investigate the diagnostic value of MRI combined with blood vitamin B12 and hemoglobin in subacute combined degeneration(SCD)of spinal cord.Methods:The clinical and MRI data of 41 patients who were clinically diagnosed as SCD were retrospectively analyzed,and they were divided into two groups,group A(MRI positive)and group B(MRI negative)according to whether there was any abnormality in spinal cord MRI.The content of blood vitamin B12,hemoglobin levels and abnormal MRI signals in the spinal cord were analyzed and compared.Results:There were 12 cases in group A,among them,8 cases had typical manifestations involving the posterior cord and/or lateral cord,the mean hemoglobin was(109.4±15.2)g/L,and the mean blood vitamin B12 was(141.0±39.2)ng/mL;and 4 cases had atypical manifestations involving the gray matter of the spinal cord and the posterior and lateral cords,the mean hemoglobin was(115.1±17.5)g/L,and the mean blood vitamin B12 was(182.8±101.9)ng/mL;the range of abnormal signals of 12 cases exceeded 3 vertebral bodies,and the morphology of the spinal cord showed no obvious swelling.In group B,there were 29 cases,the mean hemoglobin was(134.7±16.2)g/L,and the mean blood vitamin B12 was(199.2±31.4)ng/mL.There was a statistically significant difference in hemoglobin levels between groups A and B(P<0.05),but no significant difference in blood vitamin B12 levels(P>0.05).Conclusions:The MRI manifestations of spinal cord SCD have certain specificity,and there is a certain correlation between hemoglobin level and imaging signs.Knowing the typical and atypical manifestations and combining hemoglobin examination can help improve the diagnosis level of the disease.

关 键 词：脊髓 亚急性联合变性 磁共振成像 维生素B12 血红蛋白 

分 类 号：R445.2[医药卫生—影像医学与核医学] R744.6[医药卫生—诊断学]