Cobalamin deficiency with myelopathy: MRI findings

We described a 61-year-old man with cobalamin deficiency presenting with thoracic myelopathy for one month. Initial T2-weighted MR images revealed abnormal symmetrical hyperintense signal at posterior column of the spinal cord between T7 and T10 levels. The vertebral bone marrow depicted abnormal hypointense signal on both T1 and T2-weighted images. Subsequent serological test confirmed cobalamin deficiency. Although only few cases have been reported, abnormal MRI findings on the spinal cord and vertebral bone marrow should alert clinicians to consider Cobalamin deficiency. Laboratory tests should be performed to confirm the diagnosis. In our case, follow-up MRI findings correlated well with clinical outcome after treatment.