From the Departments of Radiology (R.M.K., V.D.B., J.E.S., S.M.)
From the Departments of Radiology (R.M.K., V.D.B., J.E.S., S.M.).
AJNR Am J Neuroradiol. 2023 Jan;44(1):105-110. doi: 10.3174/ajnr.A7724. Epub 2022 Dec 15.
Sarcoidosis is a multisystem granulomatous disease, with intramedullary spinal cord involvement seen in <1% of cases. This case series illustrates the clinical presentations and imaging findings of 5 patients with intramedullary spinal neurosarcoidosis occurring at sites of spondylotic spinal canal stenosis, which can be indistinguishable from spondylotic myelopathy with cord enhancement. Both entities are most common in middle-aged men and present with weeks to months of motor and sensory symptoms. On imaging, both can have focal spinal cord enhancement and longitudinally extensive signal abnormality centered at or just below the level of spinal canal stenosis. On the basis of our experience, we suggest that in patients with cord enhancement centered at or just below a site of spinal canal stenosis, consideration should be given to chest imaging and lymph node biopsy when applicable, to assess for the possibility of underlying sarcoidosis before surgical decompression.
结节病是一种多系统肉芽肿性疾病，<1%的病例累及脊髓内。本病例系列说明了 5 例发生在伴有脊髓狭窄的脊柱狭窄部位的脊髓内神经结节病的临床表现和影像学发现，这与伴有脊髓增强的脊髓型颈椎病无法区分。这两种情况在中年男性中最常见，表现为数周至数月的运动和感觉症状。在影像学上，两者都可以有局灶性脊髓增强和以脊髓狭窄部位为中心或稍下方的长节段信号异常。根据我们的经验，我们建议对于脊髓增强位于脊髓狭窄部位或稍下方的患者，应考虑进行胸部影像学和淋巴结活检（如适用），以评估是否存在潜在的结节病，然后再进行手术减压。
