Numaguchi Y, Rigamonti D, Rothman M I, Sato S, Mihara F, Sadato N
Department of Radiology, University of Maryland Medical System, Baltimore 21201.
Radiographics. 1993 May;13(3):545-59; discussion 559-60. doi: 10.1148/radiographics.13.3.8316663.
Magnetic resonance (MR) imaging with gadopentetate dimeglumine was performed in 25 patients with spinal epidural abscess (SEA). Seventeen of 25 patients underwent follow-up MR imaging. The studies were retrospectively reviewed. In 20 patients, diskitis was the primary infectious foci; however, five patients developed diffuse SEA without diskitis. The two most common MR appearances were (a) homogeneous or heterogeneous enhancement of the solid portion of the SEA and (b) thin or thick enhancement around the liquefied collections of pus. Dural enhancement was frequently seen in patients with lengthy vertebral involvement of SEA. Engorgement of the epidural venous plexus or basivertebral veins was occasionally observed. The changes in abscess size noted on follow-up studies correlated well with clinical improvement or deterioration in most patients. Persistent contrast enhancement, however, was frequently noted at the site of diskitis, osteomyelitis, or surgical drainage sites despite clinical improvement. Careful correlation of MR imaging findings with clinical findings and laboratory data is important in predicting prognosis for these patients.
对25例脊柱硬膜外脓肿（SEA）患者进行了钆喷酸葡胺磁共振（MR）成像检查。25例患者中有17例接受了随访MR成像检查。对这些研究进行了回顾性分析。20例患者中，椎间盘炎是主要感染灶；然而，5例患者发生了无椎间盘炎的弥漫性SEA。两种最常见的MR表现为：（a）SEA实性部分均匀或不均匀强化；（b）脓液液化聚集周围薄或厚的强化。在SEA累及椎体较长的患者中经常可见硬脊膜强化。偶尔观察到硬膜外静脉丛或椎基底静脉充血。在大多数患者中，随访研究中脓肿大小的变化与临床改善或恶化密切相关。然而，尽管临床有所改善，但在椎间盘炎、骨髓炎或手术引流部位仍经常可见持续的对比剂强化。将MR成像结果与临床结果和实验室数据进行仔细对比，对于预测这些患者的预后很重要。
