硬膜外麻醉神经并发症的MRI表现

MRI Diagnosis of Nerve Complications for Epidural Anesthesia

目的探讨硬膜外麻醉神经并发症的MRI诊断价值。资料与方法对12例硬膜外麻醉出现神经并发症的MRI资料进行回顾性分析,重点观察椎管内结构的形态、MRI信号特征。结果脊髓损伤4例,1例合并硬膜外血肿,表现为髓内条状长T1、长T2信号;单纯硬膜外血肿5例,表现为梭形或半月形T1、T2不均匀高信号;硬膜外脓肿3例,表现为硬膜后外方梭形或长圆形稍长T1、长T2信号,增强扫描脓肿壁明显强化。诊断结果与临床和术后诊断结果符合。结论MRI对硬膜外麻醉神经并发症诊断具有很大价值,宜作为首选方法。

Objective To investigate the value of MRI in the diagnosis of nerve complications for epidural anesthesia. Materials and Methods MRI findings of 12 cases with nerve complications for epidural anesthesia were retrospectively analyzed, the MR intensity of intraspinal canal were observed. Results In 12 patients, there were spinal cord injury （n = 4） with pieces of long T1WI signal and long T2WI signal in intramedullary on MR images, epidural hematoma （n = 5） with crescent or long ribbon of uniform hyperintensity on T1 and T2, epidural abscess （ n = 3） with similar shuttle or lone-round shape of long TI signal and long T2 signal on MR images with wall enhancement. The diagnosis were concordant with surgical and pathological results. Conclusion MR imaging is the best method in the diagnosis of nerve complications after epidura anesthesia.