MRI不同扫描方位在脊髓亚急性联合变性诊断中的价值

Value of MRI different scanning directions in the diagnosis of subacute combined degeneration of spinal cord

目的:探讨MRI不同扫描方位在脊髓亚急性联合变性诊断中的特点,以提高诊断准确率。方法:收治脊髓亚急性联合变性患者18例,采用MRI检查,总结MRI特征。结果:18例患者MRI均得到明确显示,14例矢状位脊髓后部略微肿胀,T1WI呈等或稍低信号,T2WI呈条带状高信号;16例轴位T2WI表现为脊髓后索对称性斑点状、"倒V字形"高信号;18例轴位DWI序列呈明显高信号,相应ADC值降低;4例增强扫描均无明显异常强化。结论:MRI轴位T2WI,尤其是轴位DWI序列对脊髓亚急性联合变性的检出较为敏感,结合临床实验室检测能够做出脊髓亚急性联合变性的定性诊断,有利于临床治疗及预后。

Objective:To explore the characteristics of MRI different scanning directions in the diagnosis of subacute combineddegeneration of spinal cord,in order to improve the accuracy of diagnosis.Methods:18 patients with subacute combineddegeneration of spinal cord were selected.They were given MRI examination,and we analyzed the MRI characteristics.Results:MRI of 18 patients were clearly displayed;the posterior part of the spinal cord of 14 cases was slightly swollen in sagittal position;T1WI displayed equal signal or slightly low signal;T2WI displayed strip high signal.In axial view of 16 cases,T2WI displayedfuniculus posterior medullae spinalis symmetrical spots,"reverse V" high signal.In axial view of 18 cases,DWI sequence displayedobvious high signal;the corresponding ADC value was reduced.4 cases with enhanced scan did not have obvious abnormalenhancement.Conclusion:In MRI axial view T2WI,especially axial view DWI sequence was sensitive to the diagnosis of subacutecombined degeneration of the spinal cord.Combined with clinical laboratory testing,we can make qualitative diagnosis of subacutecombined degeneration of spinal cord,which was helpful for clinical treatment and prognosis.