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Abstract：
OBJECTIVE: Spinal sarcoidosis, referring to involvement of the spine in sarcoidosis, is relatively rare and may mimic other neurological disease affecting the spine. The authors present a clinic radiological review of 18 spinal sarcoidosis patients who presented to a tertiary hospital, with emphasis on initial imaging and radiological response to treatment.
METHODS: We retrospectively reviewed our departmental imaging archives over a 15-year period and found 49 cases of neurosarcoidosis out of which 18 patients had spinal magnetic resonance imaging.
RESULTS: Approximately 72% (13/18) of the neurosarcoidosis patients showed some form of spinal involvement. The clinical, epidemiological and imaging data were reviewed for these 13 patients at presentation and follow-up. The findings on magnetic resonance imaging included leptomeningeal enhancement (61%), pachymeningeal (23%), intramedullary enhancing lesions (38%) and bony involvement (15%). The cervical segment was most frequently involved followed by the thoracic segment. Involvement was often long segment (4.2 spinal segments) with proclivity for the dorsal cord. Mean follow-up was 23.2 months. A complete or near-complete radiological response occurred in 66% while partial response was seen in 25% patients. Four patients had isolated central nervous system involvement including one with isolated spinal cord involvement. On diffusion-weighted imaging, the apparent diffusion coefficient of intramedullary lesions was increased compared to normal-appearing cord on baseline and subsequent follow-up scans.
CONCLUSIONS: Spinal sarcoidosis was previously considered uncommon but is being increasingly recognized with widespread use of magnetic resonance imaging. Proclivity for dorsal surface involvement is characteristic, although not necessarily pathognomonic. Also, quantitative diffusion studies may serve as a biomarker for the disease activity and parenchymal injury.
METHODS: We retrospectively reviewed our departmental imaging archives over a 15-year period and found 49 cases of neurosarcoidosis out of which 18 patients had spinal magnetic resonance imaging.
RESULTS: Approximately 72% (13/18) of the neurosarcoidosis patients showed some form of spinal involvement. The clinical, epidemiological and imaging data were reviewed for these 13 patients at presentation and follow-up. The findings on magnetic resonance imaging included leptomeningeal enhancement (61%), pachymeningeal (23%), intramedullary enhancing lesions (38%) and bony involvement (15%). The cervical segment was most frequently involved followed by the thoracic segment. Involvement was often long segment (4.2 spinal segments) with proclivity for the dorsal cord. Mean follow-up was 23.2 months. A complete or near-complete radiological response occurred in 66% while partial response was seen in 25% patients. Four patients had isolated central nervous system involvement including one with isolated spinal cord involvement. On diffusion-weighted imaging, the apparent diffusion coefficient of intramedullary lesions was increased compared to normal-appearing cord on baseline and subsequent follow-up scans.
CONCLUSIONS: Spinal sarcoidosis was previously considered uncommon but is being increasingly recognized with widespread use of magnetic resonance imaging. Proclivity for dorsal surface involvement is characteristic, although not necessarily pathognomonic. Also, quantitative diffusion studies may serve as a biomarker for the disease activity and parenchymal injury.
摘要：
目的：脊柱结节病，提到脊柱受累于结节病，是相对罕见的，可能模仿影响脊柱的其他神经系统疾病。作者介绍了18例三级医院的脊柱结节病患者的临床放射学回顾，重点是初始成像和放射学对治疗的反应。
方法：我们回顾性回顾了我们15年的科室影像档案，发现49例神经结节病，其中18例患者进行了脊柱磁共振成像。
结果：大约72%（13/18）的神经结节病患者表现出某种形式的脊髓受累。临床，在就诊和随访时对这13例患者的流行病学和影像学资料进行了回顾。磁共振成像的发现包括软脑膜增强（61％），厚膜(23%),髓内增强病变（38％）和骨受累（15％）。宫颈段最常见，其次是胸段。受累通常是长段（4.2脊柱段），背侧索倾向。平均随访23.2个月。66％的患者出现完全或接近完全的放射学反应，而25％的患者出现部分反应。四名患者有孤立的中枢神经系统受累，其中一名患有孤立的脊髓受累。在弥散加权成像中，在基线和随后的随访扫描中,髓内病变的表观扩散系数与正常脊髓相比增加.
结论：脊髓结节病以前被认为并不常见，但随着磁共振成像的广泛使用，其认识越来越多。背侧表面受累是特征性的，虽然不一定是pathognomonic。此外，定量扩散研究可以作为疾病活动和实质损伤的生物标志物。
方法：我们回顾性回顾了我们15年的科室影像档案，发现49例神经结节病，其中18例患者进行了脊柱磁共振成像。
结果：大约72%（13/18）的神经结节病患者表现出某种形式的脊髓受累。临床，在就诊和随访时对这13例患者的流行病学和影像学资料进行了回顾。磁共振成像的发现包括软脑膜增强（61％），厚膜(23%),髓内增强病变（38％）和骨受累（15％）。宫颈段最常见，其次是胸段。受累通常是长段（4.2脊柱段），背侧索倾向。平均随访23.2个月。66％的患者出现完全或接近完全的放射学反应，而25％的患者出现部分反应。四名患者有孤立的中枢神经系统受累，其中一名患有孤立的脊髓受累。在弥散加权成像中，在基线和随后的随访扫描中,髓内病变的表观扩散系数与正常脊髓相比增加.
结论：脊髓结节病以前被认为并不常见，但随着磁共振成像的广泛使用，其认识越来越多。背侧表面受累是特征性的，虽然不一定是pathognomonic。此外，定量扩散研究可以作为疾病活动和实质损伤的生物标志物。
