Clinical features and MRI characteristics of 12 cases of tuberculous radiculomyelitis

doi:10.19983/j.issn.2096-8493.20220045

Abstract

Abstract:

Objective: To summarize and analyze the clinical features and magnetic resonance imaging (MRI) characteristics of tuberculous radiculomyelitis (TBRM). Methods: A retrospective study was conducted on 12 patients with TBRM admitted to the Department of Internal Neurology in Hebei Chest Hospital from October 2015 to June 2021. The general data, blood routine, erythrocyte sedimentation rate (ESR), cerebrospinal fluid (CSF) test results, spinal cord and cranial MRI, lung CT, treatment regimens and prognosis of the patients were collected to analyze their clinical characteristics and spinal cord MRI characteristics. Results: Among the 12 patients, there were 11 cases of numbness and weakness of both lower limbs, 4 cases of lumbar and abdominal girdle sensation, back pain and pruritus, 4 cases of urinary and stool disorders and 3 cases of fever. There were 7 cases with tuberculous meningitis, 6 cases with active pulmonary tuberculosis, and 1 case with spinal tuberculosis. The blood leukocyte level and blood neutrophil ratio in 12 cases were in the normal range, the ESR in 6 cases was increased. and the blood T-SPOT.TB results in 5 cases were positive. CSF testing in 12 patients showed positive pathogenesis in 3 cases, normal pressure in 11 cases, elevated white blood cells in 10 cases, elevated protein in 10 cases, decreased glucose in 3 cases, decreased chloride in 7 cases, and increased adenosine deaminase in 5 cases. The MRI manifestations of spinal cord in 12 patients were spinal cord edema in 10 cases, syringomyelia in 2 cases and spinal cord membrane enhancement in 4 cases. Conclusion: TBRM is clinically rare and is closely related to tuberculous meningitis, pulmonary tuberculosis and spinal tuberculosis. Its CSF is predominantly elevated in protein, and spinal cord MRI can show spinal cord edema, syringomyelia and meningeal enhancement. Therefore, the possibility of TBRM should be considered based on spinal cord symptoms following tuberculosis infection.

Key words: Tuberculosis, Central nervous system, Spinal cord, Magnetic resonance imaging

CLC Number:

R529.3
R741

Li Junxia, Meng Yizhe, Zhang Yanan, Chen Yanqiang, Zhao Qing. Clinical features and MRI characteristics of 12 cases of tuberculous radiculomyelitis[J]. Journal of Tuberculosis and Lung Disease , 2022, 3(4): 296-299. doi: 10.19983/j.issn.2096-8493.20220045

Figures/Tables 2

References 13

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序号	性别	年龄(岁)	脊髓受累部位	主诉
1	女	38	胸椎4~11脊髓,脊膜	双下肢麻木无力
2	女	43	颈胸段脊髓、脊膜,脊髓空洞症	双下肢麻木无力,脐以下感觉减退
3	男	45	颈胸腰段脊膜	双下肢麻木无力
4	女	47	胸椎5~9脊髓水肿伴脊膜强化	发热,腹部皮肤麻木,双下肢无力,尿便障碍,共济失调
5	男	49	胸椎10~11脊髓	胸背部疼痛,双下肢麻木无力,尿便障碍
6	男	51	胸髓脊髓、脊膜	双下肢无力
7	男	53	胸2-胸11,脊髓空洞	腰背部瘙痒,双下肢无力,尿便障碍
8	男	56	颈胸腰段脊髓	四肢麻木无力,尿便障碍
9	男	56	胸椎10至腰椎1脊髓,脊髓水肿	双下肢麻木无力,共济失调
10	男	60	胸椎8~9脊髓	小便困难,鞍区麻木
11	女	69	胸髓	发热,双下肢无力
12	男	73	胸椎3~8脊膜	发热,意识障碍,双下肢麻木无力,束带感,鞍区麻木

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