MR findings of spinal epidural hematomas

Feng Chi Chang, Jiing Feng Lirng, Chao Bao Luo, Hsiu Mei Wu, Wan Yuo Guo, Michael Mu Huo Teng, Cheng Yen Chang

Research output: Contribution to journalArticlepeer-review

Abstract

Spinal epidural hematomas (SEH) are rare entities with variable clinical and MR presentations. The MR findings could mimic some spinal epidural tumors or inflammatory processes, especially when the disease is acute and under contrast-enhanced images. We retrospectively reviewed 13 cases of SEH, including their clinical findings, MR findings, treatment and prognosis. With emphasis on the early MR findings of SEH, we hope to prompt early diagnosis and management of this disease. In the acute stage (<30 hours), we found the SEH presenting as homogeneous isointensity on T1WI and homogeneous hyperintensity on T2WI of MRI. After 30 hours of symptoms onset, both T1WI and T2WI were heterogeneous hyperintensity. Increased heterogeneity of the SEH was found as time progressed. Three of 5 cases received intravenous contrast media and showed enhancement of the SEH on MRI. Causes of these enhancements were suggested as extravasation of contrast media during the acute stage of SEH or engulfed epidural vascular soft tissue during enlargement of the SEH. Contrast enhancement of SEH indicates an acute and active lesion which needs aggressive management. About prognosis of the patients of SEH, the neurological status after symptoms onset had better correlation than the way of management. In conclusion, acute SEH shows typical MR findings including contrast enhancement. These should not be confused with inflammatory or neoplastic lesions.

Original languageEnglish
Pages (from-to)289-295
Number of pages7
JournalChinese Journal of Radiology
Volume27
Issue number6
StatePublished - Dec 2002

Keywords

  • MRI
  • Spinal epidural hematomas

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