颈椎病治疗致脊髓硬膜外血肿的MRI诊断

MRI Diagnosis of Spinal Epidural Hematoma due to Treating of Cervical Spondyllosis

目的 对颈椎病例治疗致脊髓硬膜外血肿 (SEH)的MR和临床表现进行评价。方法 本组 4例SEH的患者均在二级以上医院诊断为颈椎病 ,行按摩治疗而急性发病。均作MRI检查 ,并有手术病理证实。结果 在MRI图像上 ,血肿分别位于硬膜外腔的左后、右后及正后方。 1例血肿与椎间盘突出部位相一致。T1加权能准确地显示血肿的部位及范围而最有价值 ;T2 加权反映血肿随时间发生的信号变化。出血量少时 ,显示欠佳 ,但梯度回波序列可弥补其不足。结论 颈椎病治疗致SEH虽属少见 ,但应引起医务工作者重视 ,要获得理想的临床疗效 ,就必须做到诊断准确 ,并及时地手术治疗 ,解除脊髓压迫。

Objective To evaluate MR findings and clinical data of due to treating of cervical spondyllosis with spinal epidural hematoma (SEH). Methods Four patients of SEH with underwent magnetic resonance imaging.Four patients diagnosed the illness as cervical spondyllosis in above grade two hospital,and massaged break out in emergency.All the cases were proved with surgery and pathology. Results On MRI,the hematomas were in left posterior,right posterior and posterior epidural space,respectively.Of them a hematoma was associated with disc hemiation.T 1\|weighted images were most useful in displaying accurate position and range.T 2\|weighted images reflect its signal charge with the hematoma time.It was not clear enough in images when hemorrhage amount is less,but gradient echo sequences are capable of redeeming the defect. Conclusion Although SEH that is caused by treating of cervical spondyllosis is rare,it should be taken seriously by medical staff.MRI is the most helpful diagnostic tool for this condition.It should be stressed that precise neuroradiological diagnosis and prompt surgical decompression of the spinal are essential to obtain an excellent clinical outcome. [