椎管内硬膜外脓肿的MRI诊断价值和临床意义.pdf

·论 著· 2009 年8 月第47 卷第24 期 椎管内硬膜外脓肿的MRI 诊断价值和临床意义 陈世净 （四川省富顺县中医院放射科，四川富顺643200） [摘要] 目的探讨低磁场MRI 在椎管内硬膜外脓肿的影像学表现特点和形成机制，评价其价值和临床意义。方法对23 例椎 管内硬膜外脓肿的影像学表现进行回顾性分析、对比，并对其MRI 影像表现进行总结，评价MRI 平扫和增强的信号变化方式 和特点。结果椎管内硬膜外脓肿通过其MRI 信号的不同、强化形式和方式的不同，对其性质的判断有明显的帮助。结论MRI 对椎管内硬膜外脓肿的诊断和显示病变的部位、大小、数目、形态以及对临床治疗方式的选择、预后判断具有不可替代的作用， 特别是MRI 增强扫描在显示病变的部位、范围，以及对椎管内硬膜外脓肿的早期诊断均明显优于普通平片、CR、DR 和CT。 [关键词] 硬膜外脓肿；MRI ；诊断 [中图分类号] R632.504 A [文章编号] 1673- 9701 （2009）24- 10- 03 [文献标识码] MRI Diagnost ic Value and It s Clinical Significance in Spinal Epidural Abscess CHEN Shij ing Department of Radiology，Chinese Medicine Hospital of Fushun County，Sichuan 643200，China [Abst ract ] Object ive To investigate the imaging features and formation mechanism of low- field MRI for spinal epidural abscess and evaluate its clinical value. Met hods The imaging findings of 23 cases of spinal epidural abscess were retrospectively analyzed and compared ，and the MRI imaging manifestations were summarized ，and MRI plain scan and the way and characteristics of enhanced MRI signal changes were evaluated. Result s Different MRI signals and different enhanced forms and ways could help judge the nature of spinal epidural abscess. Conclusion MRI used for the spinal epidural abscess diagnosis ，for the site，size，number and shape of the lesion ，for the selection of clinical treatments and for the prognosis judgement has an irreplaceable role ，and besides，MRI is significantly superior to common X ray plain film，CR，DR and CT in the early diagnosis of spinal epidural abscess. [Key Words] Epidural abscess；MRI ；Diagnosis 椎管内硬膜外脓肿是一种较常见病，如果延误诊断，治疗不 取仰卧位，保持平稳呼吸。脊柱颈段选