椎管内血肿的影像学表现

目的探讨椎管内血肿的CT及MRI表现特点，提高椎管内血肿CT及MRI表现的认识。方法回顾分析18例经手术及临床治疗随访复查证实的椎管内血肿的CT及MRI表现。18例患者均常规CT、MR平扫，其中2例MR增强扫描。使用GE公司Lightspeed16CT扫描仪，及Phillip1．5TAcheive超导MR扫描仪，2例MR增强扫描采用钆喷酸葡甲胺（Gd—DTPA）对比剂经静脉团注，注射剂0．1mmol/kg。结果颈胸段3例，胸段5例，胸腰段6例，腰段4例；位于脊髓背侧方14例，脊髓两侧2例、腹侧2例。硬膜外血肿11例，硬膜下血肿6例，硬膜外血肿并蛛网膜下腔内积血1例。CT表现为高密度或等密度，MRI分别呈长T1长T2信号、长T-短Tz信号、等T1短T2信号及短T1长T2信号，其中2例MR增强扫描，1例边缘强化，1例未见强化。结论椎管内血肿的CT、MRI表现具有一定的特征性，对其定性定位诊断及鉴别诊断有着重要的价值。

Imaging manifestations of hematoma in spinal canal

Objective To investigate the CT and MRI imaging characteristics of hematoma in spinal canal so as to impro ving the understanding of this disease. Methods 18 patients with spinal canal hematoma of confirmed by surgery and elini cal follow-up were retrospective reviewed. 18 patients were subjected to CT and MRI scan, of which 2 to the enhanced MR scanning. GE Lightspeed 16 CT scanner and Phillip 1.5 T acheive superconducting MR scanner were used. As for the 2 cases underwent the enhanced MR scanning, gadolinium spray acid meglumine （Gd-DTPA） contrast agent was used by in travenous injection, with injection dose of 0.1 mmol/kg. Results 3 cases were found in neck thoracic segment, 5 cases in thoracic segments, 6 cases in chest and waist segment, and 4 cases in waist section. 14 cases were located in the spinal cord dorsal side, 2 cases on both sides of the spinal cord, and 2 cases in ventral side. There were 11 cases of epidural he matoma, 6 cases of a subdural hematoma, and 1 case of epidural hematoma and subarachnoid hemorrhage. CT performance appeared high density or equal density. MRI manifestations included a long T1/ long T2 signal, long T1/short T2 signal, equal T1/short T2 signal, and short T1/long T2 signal. With respect to the 2 cases to enhanced MR scan, one was shown edge reinforcement and the other was not seen reinforcement. Conclusion The CT and MRI features of spinal canal hema toma have certain characteristics and the qualitative positioning diagnosis and differential diagnosis have important values.