摘要
目的:探讨笑气滥用致脊髓亚急性联合变性(SCD)的临床和影像学特征。方法:回顾性分析4例笑气滥用致脊髓亚急性联合变性患者的临床与影像学资料并复习文献,总结其临床和影像学特征。结果:4例患者为17~30岁青少年,男3例,女1例,均以四肢麻木无力起病,渐进性加重;实验室检查均伴有血清同型半胱氨酸水平升高,其中2例血清Vit B_(12)水平下降;神经电生理显示四肢感觉和运动神经均受损;磁共振检查T_(2)WI轴位颈段脊髓后索见长节段倒“V”征高信号;停用笑气、补充Vit B_(12)治疗,所有患者症状均较前改善。结论:笑气滥用导致脊髓亚急性联合变性多见于青少年,高同型半胱氨酸血症和脊髓倒“V”征是重要诊断依据,早期诊断并停用笑气、及时补充Vit B_(12)预后较好。
Objective:To assess the clinical and imaging features of subacute combined degeneration of the spinal cord(SCD)by nitrous oxide abuse.Methods:The clinical and imaging data of four patients with SCD by nitrous oxide abuse were analyzed retrospectively,and relevant literatures were reviewed to summarize the clinical and imaging features.Results:Four young patients aged from 17 to 30,3 males and 1 females.The onset was chronic or subacute,and main initial symptoms were paresthesia of hands and feet.Laboratory examination,elevated serum homocysteine levels in 4 patients and low serum vitamin B_(12) level in 2 patients.Electrophysiological examinations,revealed sensory and motor nerve involvement in 4 patients,included axonal degeneration and demyelination.Spinal magnetic resonance imagings showed that long segmental lesions were present in the cervical spinal cord of all the patients,the horizontal axis had an“inverted V sign”T_(2) high signal.The symptoms in these 4 cases were alleviated in varying degrees after stopping the inhalation of nitrous oxide and actively supplementing high doses of vitamin B_(12).Conclusion:N_(2)O abuse-related SCD has been most common among youth,which should have strong evidences on high levels of homocysteine and spinal“inverted V sign”.The prognosis would be good after stopping inhalation of N_(2)O and vitamin B_(12) supplementation.
作者
戴美娜
吴白龙
卢虹
Dai Meina;Wu Bailong;Lu Hong(CT and MRI Room,Bengbu Third People’s Hospital,Benbu,Anhui 233000)
出处
《现代医用影像学》
2022年第6期1028-1031,共4页
Modern Medical Imageology
