加强管理使医院在竞争中实现社会效益最大化

目的：探讨急性自发性椎管内硬膜外血肿的影像学表现特点。方法：7例自发性椎管内血肿，男4例，女3例，年龄14岁-59岁，平均年龄45岁，所有病例均无明显外伤史，7例均行CT和MR扫描，1例行CT强化扫描，2例行MR强化扫描。结果：血肿位于颈段2例，发生在胸段5例，CT扫描主要表现为偏向椎管背侧或腹侧连续多个节段的新月形或双凸形高密度影，注射造影剂后病变不强化。MR扫描显示本组有5例血肿位于脊髓背侧，2例位于脊髓腹侧。矢状位呈新月形或条状异常信号，分别跨越3个-5个脊髓节段，7例血肿T1WI和T2WI均呈高信号，脂肪抑制像也为高信号，有2例行MR增强扫描病灶未见强化。结论：CT和MR都是诊断急性自发性椎管内硬膜外血肿的最有效检查方法，二者结合更有利于显示血肿部范围和脊髓损害情况。

Medical Imaging Diagnosis of Acute Spontaneous Spinal Epidural Hematoma

Objective To explore the medical imaging feature of spontaneous spinal epidural hematoma. Methods There were 7cases of acute spontaneous spinal epidural hematoma consisted of 4 cases of male and 3 cases of female. The age were ranged from 14 to 59 years old with average age 45. All cases were examined by CT and MR. 1 case wasexamined by CT enhancement scan and 2 cases were examined MR enhancement scan. Results There were 2 cases at neck segment ,5 cases at thoracal segment. The hematomas located at the posterior of spinal cannel and face ventralis spinal cannel on CT axial images, the shape of hematomas was like crescent and biconvex with high-density. The hematoma was not enhanced in 1 case on CT enhancent scan. The hematomas located at the posterior of spinal cannel in 5 cases and the face ventralis spial cannel in 2 cases on MR sagittal images ,the shape of hematoma was like crescent or long ribbon. The hematomas covered 3 to 5 spinal cord segments. Hematomas in 7 cases were high signal on T1 WI,T2WI and STIR. The hematomas were not enhanced in 2 cases on MR enhancent scan. Conclusion CT and MR imaging are the most effective methods to diagnose the hematoma of acute spontaneous spinal epidural. CT combined MR can show very clearly the range of spinal epidural hematoma and the injury of spinal cord.