摘要
目的分析非创伤性硬膜外血肿 的MR影像学表现及其鉴别诊断。方法 10 例非创伤性硬膜外血肿患者行常规MR平 扫,其中7例行MR增强扫描,9例经手术病 理证实,1例经MR复查证实。结果 血肿 发生于颈段4例,颈胸段3例,胸段3例; 血肿位于脊髓背侧8例,腹侧1例,腹侧背 侧均有血肿1例,血肿形状7例呈梭形,2 例呈环状、条形,1例为长圆形;术后证 实血管出血2例,血管瘤2例,血管畸形1 例,急性期血肿T1WI稍高信号,T2WI稍低 信号,亚急性期血肿T1WI呈等或高信号, T2WI呈低或高信号,慢性期血肿呈等信 号。强化方式因出血原因、时间而有所不 同。结论 MR是诊断非创伤性硬膜外血肿 最有价值的手段,可准确显示病变范围, 正确判读血肿时期,并对分析出血原因可 提供一定的帮助。
Objective To analyze the MR manifestations and differential diagnosis of nontraumatic spinal epidural hematoma. Methods 10 patients with nontraumatic spinal epidural hematoma were performed MR plan scan, 7 of which enhanced. 9 cases were proved by surgery and pathology and 1 case were proved by follow up. Results Hematoma occurred in cervical level in 4 cases, cervical-thoracic level in 3 cases and thoracic level in 3 cases. Hematoma were located in the dorsal of spinal cord in 7cases, located in the ventral of the spinal cord in 1 case and both in 1 case. The hematomas in 7 cases were spindle-shaped, 2 were strip-shaped and 1 was oval. Vessel bleeding were found in 2 case, angioma in 2 case and AVM in 1 case by surgery. Hematoma were demonstrated slight hyper intensity on T1WI and slight hypo intensity on T2WI in acute phase. In subacute phase, hematoma showed iso- or hyper signal intensity on T1WI, hypo- or hyper intensity on T2WI, and isointensity on both sequences in chronic phase. The enhanced pattern was different towards period and different reason. Conclusions MR is valuable in diagnosing the nontraumatic spinal epidural hematoma with presenting the extend of lesions precisely, judging the phase of hematoma correctly and help in analyzing the reason some degree.
【关键词】脊髓;硬膜外血肿
【中图分类号】R651.2
【文献标识码】A
【DOI】10.3969/j.issn.1672-5131.2015.03.32
前言
非创伤性脊髓硬膜外血肿(nontraumatic spinal epidural hematoma, NSEH)是一种相对少见的疾病,文献报道NSEH的发生率约为 0.1/10万人[1],在脊髓硬膜外占位性病变的比例不到1%。NSEH临床症 状不典型,因此诊断较为困难。本组病例收集自2008年7月至2013年8 月我院10例经手术病理或临床证实的NSEH,所有病例均行MRI检查,复 习相关文献,对临床资料及MRI影像学表现进行回顾分析。
中国CT和MRI杂志
第13卷, 第 3 期
2015年03月
相关文章