Spinal Magnetic Resonance Imaging Manifestations at Neurological Onset in Japanese Patients with Spinal Cord Sarcoidosis
Spinal Magnetic Resonance Imaging Manifestations at Neurological Onset in Japanese Patients with Spinal Cord Sarcoidosis
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DOI：
10.2169/internalmedicine.52.0186
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发表时间：
2013-01-01
影响因子：
1.2
通讯作者：
Sugimoto, Hideharu
中科院分区：
文献类型：
--
作者：
Kobayashi, Shigeru;Nakata, Waka;Sugimoto, Hideharu
目的：我们回顾性研究了日本脊髓结节病患者在神经症状发作时的脊髓磁共振成像（MRI）表现。
方法：在2000年7月至2012年4月期间，我们查阅数据库并招募了脊髓结节病患者。对在神经症状发作时进行的脊髓MRI，评估以下项目：髓内T2加权像上高信号病变的椎体节段分布和长度、异常强化模式及分布，以及是否同时存在脊椎病和相关的脊髓外病变。如果有脑部MRI扫描结果，也一并进行评估。
结果：共纳入9例患者（4例男性，5例女性；中位年龄49岁）。反映日本的流行病学背景，在年轻男性和中年女性中观察到发病倾向。8例患者存在髓内T2加权像高信号病变，在C5水平最为明显，平均长度为3.7±2.6个椎体节段。中年患者同时存在脊椎病。6例患者观察到髓内异常强化且同时累及神经根，根据疾病进展情况可分为两种类型：沿脊髓表面的线性和/或结节状强化，以及由靠近脊髓表面的斑片状、宽基底强化组成的髓内强化。5例患者有相关的脊髓外病变，其中4例有淋巴结肿大，4例有脑部受累。
结论：在日本人群中，脊髓结节病在年轻男性和中年女性中具有发病倾向，其特征为髓内T2加权像高信号病变在C5水平最为明显且跨越3个以上椎体节段，有两种反映疾病进展的髓内异常强化类型，常累及神经根以及有淋巴结肿大。
Objective We retrospectively investigated spinal magnetic resonance imaging (MRI) manifestations at neurological onset in Japanese patients with spinal cord sarcoidosis.Methods Between July 2000 and April 2012, we reviewed our database and recruited patients with spinal cord sarcoidosis. On spinal MRI performed at neurological onset, the following items were evaluated: the vertebral-segment distribution and length of intramedullay T2-elongated lesions, abnormal enhancement patterns and distributions and the concomitant presence of spondylosis and associated extraspinal lesions. If available, brain MRI scans were concomitantly assessed.Results Nine patients were enrolled (four men and five women; median, 49 years). Reflecting Japanese epidemiological backgrounds, a predilection for occurrence was observed in young men and middle-aged women. Intramedullary T2-elongated lesions were present in eight patients, peaking at the C5 level, with a mean length of 3.7 +/- 2.6 vertebral segments. Spondylosis coexisted in the middle-aged patients. Abnormal intramedullary enhancement with concomitantly involved the nerve roots was observed in six patients, comprised of two types reflecting the disease progression: linear-and/or nodular enhancement along the surface of the spinal cord and intramedullary enhancement consisting of patchy, broad-based enhancement adjacent to the cord surface. Five patients had associated extraspinal lesions, including lymphadenopathy in four patients and brain involvement in four patients.Conclusion Spinal cord sarcoidosis exhibits a predilection for young men and middle-aged women among Japanese individuals and is characterized by intramedullary T2-elongated lesions spreading more than three vertebral segments peaking at the C5 level, two types of abnormal intramedullary enhancement reflecting disease progression, frequent nerve root involvement and lymphadenopathy.