Learning objectives
1.
To know the epidemiology,
etiology,
symptoms of vitamin B12 deficiency.
2.
To understand the typical MRI findings in patients with Subacute combined degeneration of the cord (funicular myelosis)
3.
To illustrate the modalities of writing a report.
Background
Definition:
Subacute combined degeneration of the spinal cord ( SCD ) - is a systemic spongy vacuolation and myelin degeneration due to vitamin B12 deficiency.
Typical is the involvement of the posterior and lateral columns of the spinal cord in the cervical and thoracic parts of the spinal cord.
Epidemiology:
Prevalence of Subacute combined degeneration of the spinal cord is estimated in the range from 4.8% to 12% among the elderly.
More frequently,
the disease is diagnosed in 50 - 80 years.
About 50% of...
Findings and procedure details
Traditional X-ray methods such as spondylography and CT are ineffective in diagnostics. The results of these examinations are usually normal.
The method of choice for diagnosis of this pathology is MRI of the cervical and thoracic spinal cord.
On saggital T2 tomograms,
lesions show hyperintensive signal confined to the dorsal parts of the spinal cord .
This is a typical feature of funicular myelosis - pathological hyperintensive zones capture several segments of the spinal cord.
T1w – images is usually poorly informative.
The most pathognomonic...
Conclusion
1.
Subacute combined degeneration of the cord in clinical practice is relatively rare and accurate knowledge about the etiology,
epidemiology and typical MR pattern is very important for the radiologist.
2.
MRI optimally assesses changes in the spinal cord.
3.
Imaging has a big role in early diagnosis and the prognosis of the SCD.
References
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et al.
Vitamin B12 ( cobalamin) deficiency in elderly partients .
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Naidich M.,
Ho S.
Case 87 : Subacute combined degeneration .
Radiol.,
2005,
237,
101 – 105.
Peme P.,
Horak H.,
Wyatt R.
Myelopathy caused by nitrous oxide toxicity .
AJNR.,
1998,
19,
894 – 896
Kumar,
Ashok,
and Amar Kumar Singh.
"Teaching NeuroImage: Inverted V sign in subacute combined degeneration of spinal cord." Neurology 72.1 (2009): e4-e4.