Christiansen Eric M, Kang Paul, Hughes Jeremy N
Department of Radiology, St. Joseph's Hospital and Medical Center, Phoenix, AZ, United States of America.
Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, United States of America.
Clin Imaging. 2022 Jun;86:20-24. doi: 10.1016/j.clinimag.2022.03.010. Epub 2022 Mar 14.
We determined the incidence of epidural fluid signal on spinal magnetic resonance imaging (MRI) after image-guided lumbar puncture (LP) in adults. We correlated those imaging findings with clinical status.
We searched our institution's medical records from January 2013 through April 2020 to identify adult patients who underwent image-guided LP and postdural puncture MRI. We examined the incidence of epidural fluid signal intensity in adults after image-guided dural puncture, characterized its imaging features, and evaluated its associated clinical factors.
Of 91 patients who underwent image-guided dural puncture and subsequent spinal MRI within 7 days, 18 (20%) demonstrated epidural fluid signal on postdural puncture MRI. Univariate analysis showed that larger needle size correlated with signal presence (4/8 [50%] LP with a 20-gauge needle vs 13/82 [16%] with a 22-gauge needle, P = 0.03). The odds of observing epidural fluid signal on postdural puncture MRI decreased by 8% per 1-year increase in age (P < 0.001). Postdural puncture symptoms did not differ between those with and without epidural fluid signal intensity.
Epidural fluid signal on MRI in adults may be an incidental finding more commonly observed in younger patients after dural puncture with larger needles, without a significant correlation with symptomatology.
我们确定了成人在影像引导下腰椎穿刺（LP）后脊髓磁共振成像（MRI）上硬膜外液信号的发生率。我们将这些影像学发现与临床状况相关联。
我们检索了本机构2013年1月至2020年4月的医疗记录，以识别接受影像引导下LP和硬膜穿刺后MRI检查的成年患者。我们检查了影像引导下硬膜穿刺后成人硬膜外液信号强度的发生率，描述了其影像学特征，并评估了其相关临床因素。
在91例接受影像引导下硬膜穿刺并在7天内进行后续脊髓MRI检查的患者中，18例（20%）在硬膜穿刺后MRI上显示硬膜外液信号。单因素分析显示，较大的针径与信号存在相关（20号针穿刺的8例LP中有4例[50%]出现信号，而22号针穿刺的82例中有13例[16%]出现信号，P = 0.03）。硬膜穿刺后MRI上观察到硬膜外液信号的几率每增加1岁下降8%（P < 0.001）。有无硬膜外液信号强度的患者在硬膜穿刺后症状方面无差异。
成人MRI上的硬膜外液信号可能是一种偶然发现，在使用较大针进行硬膜穿刺的年轻患者中更常见，与症状学无显著相关性。
