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目的 :探讨脊髓亚急性联合变性 (SCD)的临床特点 ,磁共振成象 (MRI)的诊断价值及病因。方法 :回顾分析了 2 5例SCD患者的临床特征。结果 :2 5例 (10 0 % )脊髓后索受损 ,13例 (5 2 % )侧索中锥体束受损 ,13例(5 2 % )侧索中脊丘束受损 ,7例 (38% )周围神经受损 ,7例 (38% )二便障碍 ,3例合并精神症状 ,17例做脊髓MR/检查 ,阳性 4例 (2 3.5 % ) ,2 4例做血清维生素B12浓度测定 ,12例 (5 0 % )血中维生素B12低于正常值。结论 :SCD除可累及脊髓后索 ,侧索中锥体束外 ,还可累及侧索中脊丘束 ,MRI对诊断有一定价值 ,维生素B12缺乏是SCD的主要病因。
Objective: To investigate the clinical features of spinal subacute combined degeneration (SCD) and the diagnostic value and etiology of magnetic resonance imaging (MRI). Methods: The clinical features of 25 patients with SCD were retrospectively analyzed. RESULTS: Twenty-five cases (10%) had posterior spinal cord injury, 13 cases (52%) suffered lateral pyramidal tract injury, 13 (52%) lateral caudal midrib ridge injury, and 7 (38%) had peripheral nerve injury, 7 cases (38%) had two defecation disorders, 3 cases had mental symptoms, 17 cases had spinal cord MR / examinations, 4 cases were positive (23.5%) and 24 cases did serum vitamin B12 Determination, 12 cases (50%) of blood vitamin B12 lower than normal. CONCLUSIONS: SCD may also involve lateral hypothalamus in addition to pyramidal tract of lateral spinal cord and posterior spinal cord. MRI may be of value in the diagnosis. Vitamin B12 deficiency is the major cause of SCD.