非外伤性脊髓硬膜外血肿的MR诊断

目的　探讨非外伤性脊髓硬膜外血肿的MR表现特点及其鉴别诊断。方法　 14例非外伤性脊髓硬膜外血肿 ,男 9例 ,女5例 ,年龄 4～ 63岁 ,平均 41.3岁。所有病例均无明显的外伤史。常规行T1W矢状位 ,T2 W矢状位及横切位扫描 ,1例行MR增强扫描。结果　 14例非外伤性脊髓硬膜外血肿中 11例位于椎管背侧 ,3例位于椎管腹侧 ,呈新月状或长条带状 ,分别累及 3～ 12个脊髓节段 ,平均 5 .2个脊髓节段。血肿位于颈胸段 4例 ,位于胸段 3例 ,位于胸腰段 5例 ,位于腰段 2例。 10例血肿T1W及T2 W均呈较均质性高信号强度 ,3例血肿T1W及T2 W呈不均质性高信号强度 ,1例于T1W呈中等信号强度 ,T2 W呈较低信号强度。 14例中 1例于血肿内可见低信号的血管流空影 ,术后证实为动静脉畸形。血肿于T1W及T2 W与脊髓之间有一低信号带相隔 ,尤以T2 W显示最佳。 2例受压脊髓于T2 W呈高信号。 1例行MR增强扫描 ,血肿壁轻度强化。结论　MR是诊断非外伤性脊髓硬膜外血肿的最佳检查方法 ,不仅可以清楚地显示血肿的部位及范围 ,而且可以清楚地显示血肿新旧程度及脊髓受损的情况

Nontraumatic Spinal Epidural Hematoma:MRI Diagnosis

Objective To investgate the MR features and differential diagnosis of nontraumatic spinal epidural hematoma. Methods There were 14 cases of nontraumatic spinal epidural hematoma consisted of 9 cases of male and 5 cases of female. The age were ranged from 4 to 63 years old with average age 41.3. All cases did not have injury history. The routine T 1W sagittal, T 2W sagittal and transverse planes were performed with MR scanner. 1 case was examined by MR enhancement scan. Results The hematomas located at the posterior of spinal cannal in 11 cases and the face ventralis spinal cannal in 3 cases,the shape of hematomas was likes crescent or long ribbon.The hematomas covered 3 to 12 spinal cord segments with average 5.2 spinal cord segments.There were 4 cases at cervicothoracal segment,3 cases at thoracal segment,5 cases at thoracolumbar segment and 2 cases at lumbar segment.Hematomas in 10 cases were uniform high signal on T 1W and T 2W,3 cases were ununiform high signal on T 1W and T 2W,1 case was medium signal on T 1W and low signal on T 2W.Among 14 cases,1 case showed low signal of flowing void imaging in hematoma,which was proved to be arteriovenous malformation by operation.There was a low signal septum between spinal cord and hematoma on T 1W and T 2W,especially clearly on T 2W.2 cases presented high signal in pressed spinal cord on T 2W.The wall of hematoma was enhanced in 1 case on MR enhancement scan.Conclusion MR imaging is the best method in diagnosis of nontraumatic spinal epidural hematoma.It can not only showes clearly the location and range of hematoma,but also the age of hematoma and the injury of spinal cord.