自发性椎管内硬膜外血肿的MRI诊断

目的探讨自发性椎管内硬膜外血肿（SSEH）的MRI特征，旨在提高对此病的认识水平。方法回顾性总结我院6例SSEH的MRI特征和相关临床资料，其中4例经手术和病理确诊，2例保守治疗随访有效。结果血肿位于颈胸段2例，胸段3例，腰段1例。5例血肿位于硬脊膜外腔后方，1例位于硬脊膜外腔侧后方，血肿累及l～3个脊髓节段。T1加权像呈等信号、Tz加权像呈高信号1例；T1加权像呈等信号、L加权像呈低信号3例；T1加权像呈高信号、T1加权像呈低信号2例。其中4例采用钆喷酸葡甲胺（Gd—DTPA）对比剂增强扫描，1例轻中度条片状强化；2例边缘轻度强化，其中1例类似环状；1例无明显强化。结论MRI易于检出自发性椎管内硬膜外血肿，可以准确显示其部位、形态、大小及周围组织的关系，可以作出定性诊断，对临床诊治具有重要价值。

MRI diagnosis of spontaneou spinal eqidural hematoma

Objective To investigate MR lectures of spontaneous spinal eqidural hematoma （SSEH） so as to improve the recongnition of the disease. Methods Clinical data and MR images of 6 cases of spontaneous spinal eqidural hematoma were retrospectively studid. 4 cases had been proved by surgery and pathology. The conservative treatment was effective in 2 cases. Results Two cases located in cervicothoracic segment, 3 in thoracic segment and 1 in lumbar segment. The he- matoma located at posterior epidural space in 5 cases and at posterior-lateral epidural space in 1 case. The hematoma cov- ered 1 to 3 spinal cord segment. 1 case showed isointense siganals on T1WI and hyperintense siganals on T2WI~ 3 cases showed isointense siganals on T1WI and hypointense siganals on T2 WI; 2 cases showed hyperintense siganals on T1 WI and hypointense siganals on T2WI. In 4 cases that underwent the enhanced scan with GD-DTPA, 1 case showed slight-moder- ate patchy enhancement. 2 cases showed slight edge enhancement, 1 looke liked a ring, and 1 showed no enhancement. Conclusion MRI is easy to detect spontaneous spinal eqidural hematoma, which can precisely assess its location, shape, size and the relationship with surrounding structure. SSEH could be accurately diagnosed with MR. MRI is valuble for di- agnosis and treatment of spontaneous spinal eqidural hematoma.