Xiao Cui-Ping, Ren Cui-Ping, Cheng Jing-Liang, Zhang Yong, Li Ying, Li Bei-bei, Fan Yi-Zhe
Department of Magnetic Resonance Imaging, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China.
Department of Magnetic Resonance Imaging, the First Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan, China. Email:
Asia Pac J Clin Nutr. 2016;25(1):34-8. doi: 10.6133/apjcn.2016.25.1.04.
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.
脊髓亚急性联合变性（SCD）常发生于维生素B12缺乏时，在T2加权像上，脊髓侧索和后索通常表现为高信号。本研究的目的是评估传统磁共振检查在诊断SCD中的应用。对36例临床确诊患者进行回顾性分析；所有患者均有常规脊柱MRI检查，其中8例有增强MRI检查。36例患者中，19例在T2加权像上显示信号异常，敏感性为52.8%，其中18例位于脊髓后方，1例位于胸段脊髓前角。脊髓异常在颈椎发现12例（33.3%），在胸椎发现7例（19.4%）。轴位T2加权像上，5例患者在颈髓表现为对称的线性T2高信号，呈“倒V”形，这是SCD的典型表现。对于胸段脊髓异常的患者，双侧成对的结节状T2高信号在胸髓处类似“双筒望远镜”。8例患者中仅1例注射造影剂后有轻微强化。所有36例患者经适当的维生素B12治疗后临床症状均有改善。两次随访脊柱MRI显示病变范围缩小。因此，传统MRI对维生素B12缺乏所致SCD的诊断和治疗有帮助。
