硬脊膜外脓肿的MRI诊断

MRI findings of spinal epidural abscess

目的 探讨MRI对硬脊膜外脓肿的诊断价值。方法 回顾性分析经手术病理或细菌培养证实的13例硬脊膜外脓肿的MRI表现。结果 根据MRI表现,硬脊膜外脓肿分为小脓腔(4例)、大脓腔(5例)、肉芽肿(2例)及纤维肉芽肿(2例)4型。病变均有占位效应,前3型病变在T1WI上与脊髓比较呈等低信号,其中残存形态不同的脂肪信号为其特征;增强扫描T1WI示大小脓腔不强化,脓肿壁、间隔及硬脊膜强化具有特征;肉芽肿型呈弥漫增强,无强化特征。纤维肉芽肿型兼具纤维组织与肉芽组织的信号特征。结论MRI对硬脊膜外脓肿的诊断及其病理特征的显示具有重要价值。

Objective ToevaluateMRIinthediagnosisofspinalepiduralabscess(SEA) .Methods TheMRIfindingsin 13patientswithSEAconfirmedbypathologyor/andbacteriologywereretrospectively analyzed .Results TheSEAwereclassifiedas 4patternsbasedonMRIappearances :smallabscesscavity ( 4cases) ,largeabscesscavity ( 5cases) ,granuloma ( 2cases)andfibroticgranuloma ( 2cases) .TheMRI appearancesofthefirstthreetypesofSEAshowedisointensetohypointesnsesignalcomparedtospinalcordon T1W1image ,characterizedbyvariousshapesoffattyislandleftinit.EnhancedT1W1withGd DTPAshowed inintensifiedlargeorsmallabscesscavity ,andcharacteristicallyintensifiedpariesanddiaphragmsofabscessand dura.MRIoffibroticgranulomashoweddiffuselyenhancedsignalswithoutintensification ,sharingthefeaturesof bothfibrotictissueandgranuloma.Conclusion MRIexaminationisofgreatvalueindiagnosisofSEA ,which maypredictthepathologiccharacteristicsofSEA .