背景:神经结节病很少见,在其表现形式中,只有少数病例报道了神经根受累。因此,神经结节病的磁共振成像(MRI)发现,特别是那些涉及神经根的,在文献中很少见。
方法:我们介绍了神经结节病累及颈神经根和颅神经,同时进行系统的文献综述。
结果:一名28岁女性突然出现右侧面部麻木以及左上肢和左手疼痛。初始脑和脊柱MRI显示左Meckel的洞穴/三叉神经中T2等高信号强度的隆起块,以及右侧C6和C7神经根的弥漫性肿大。2个月时的随访MRI显示,初始病变的大小减小,对侧出现新的相似病变(右Meckel洞穴,左C3-C8神经根)。特别是,涉及神经根的病变表现为沿神经根的中央扩大,不涉及相邻的脊髓。所有这些病变都表现出增强,导致结节病和淋巴瘤之间的区别。结节病随后通过肺门淋巴结活检证实。
结论:本报告提出了涉及脊神经根的神经结节病的独特MRI特征,代表了同类中的第一个,并描述了整个临床过程中MRI发现的演变。
BACKGROUND: Neurosarcoidosis is rare, and among its manifestations, nerve root involvement has been reported in only a few cases. Therefore, magnetic resonance imaging (MRI) findings of neurosarcoidosis, particularly those involving nerve roots, are scarce in the literature.
METHODS: We presented the
case of neurosarcoidosis involving cervical nerve roots and cranial nerves, alongside a systematic literature review.
RESULTS: A 28-year-old female suddenly developed right facial numbness as well as left upper extremity and left hand pain. Initial brain and spine MRI showed a bulging mass of T2 iso-to-high signal intensity in the left Meckel\'s cave/trigeminal nerve, as well as diffuse enlargement of the right C6 and C7 nerve roots. Follow-up MRI at 2 months revealed a reduction in the size of the initial lesion and the appearance of new similar lesions on the contralateral side (right Meckel\'s cave, left C3-C8 nerve roots). In particular, the lesions involving the nerve roots demonstrated central enlargement along the nerve roots, without involvement of the adjacent spinal cord. All these lesions exhibited enhancement, leading to the differentiation between sarcoidosis and lymphoma. Sarcoidosis was subsequently confirmed through biopsy of a hilar lymph node.
CONCLUSIONS: This report presents a distinctive MRI feature of neurosarcoidosis involving spinal nerve roots, representing the first of its kind, and describes the evolution of MRI findings throughout the clinical course.