自发性脊髓硬膜外血肿的MRI诊断(附4例报告)

Magnetic Resonance Imaging in Spontaneous Spinal Epidural Hematoma: 4 Cases Report

目的：对自发性脊髓硬膜外血肿（ＳＳＥＨ）的ＭＲ和临床表现进行评价。材料与方法：本组包括１９９６年至１９９８年的３例ＳＳＥＨ患者，男３例，女１例，年龄３３～６１岁。４例患者均无外伤、血管损伤或凝血机制障碍等病史。均作ＭＲＩ检查并有手术病理证实。结果：在ＭＲ图像上，血肿分别位于硬膜外腔的左后、右后及正后方。其中１例为ＡＶＭ导致的有包膜的血肿，另１例的局部有椎间盘突出。Ｔ１加权能特征性地反映血肿随时间发生的信号变化而最有价值；１．５Ｔ高场强和轴位梯度回波的Ｔ２加权能很好地判断血肿的位置。结论：自发性脊髓硬膜外血肿是一少见病，ＭＲＩ是它的首选检查方法。应当注意的是，要获得理想的临床疗效，就必须做到诊断精确，并及时地手术治疗，解除脊髓压迫。

Objective: To evaluate MR findings and clinical data in patients with spontaneous spinal epidural hematoma (SSEH). Materials and Methods: Three patients (3 men and 1 women, aged 3361 years) with SSEH underwent magnetic resonance imaging (MRI during 19961998). There was no history of trauma, vascular lesions or coagulation disorders. All cases were proved with surgery and pathology. Results: On MRI, the hematomas were in left posterior, right posterior and posterior epidural space, respectively. The MRI confirmed an encapsultated hematoma caused by arteriovenous malformation and a hematoma associated with disc herniation. T1weighted images were most useful owing to its typical signal charge with the hematoma age. MRI at 1.5T and transverse T2weighted gradient echo sequences are capable of identifying epidural and subdural spinal hematoma. Conclusion: SSEH is a rare entity. MRI is a most helpful diagnostic tool for this condition. It should be stressed that precise neuroradiological diagnosis and pr