Diagnosis of MRI in Spontaneous Spinal Subdural Hematoma
10.3969/j.issn.1005-5185.2025.07.016
- VernacularTitle:MRI对自发性椎管内血肿的诊断价值
- Author:
Haiyan GAO
1
;
Huishan GAO
;
Haoran HUANG
;
Liang LI
;
Jun CHEN
Author Information
1. 青岛市城阳区人民医院影像科,山东 青岛 266109
- Publication Type:Journal Article
- Keywords:
Magnetic resonance imaging;
Spinal canal;
Hematoma;
Hematoma,subdural;
Hematoma,epidural,cranial;
Conservative treatment;
Surgical procedures,operative
- From:
Chinese Journal of Medical Imaging
2025;33(7):775-779
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To summarize the MRI characteristics of patients with spontaneous spinal subdural hematoma,so as to strengthen the awareness to this disease,and to improve the clinical diagnosis and treatment ability.Materials and Methods A retrospective analysis was performed on five patients with spontaneous spinal subdural hematoma diagnosed and treated in Qingdao Chengyang District People's Hospital from January 2021 to December 2023.Plain MRI and enhanced MRI were performed 6-24 hours after onset,and the imaging characteristics were analyzed.Combined with the dynamic American Spinal Injury Association(ASIA)grading score and disease progression,three patients were treated with surgery and two patients with conservative treatment.Results All patients were followed up for 6-15 months.Among the five patients,the hematoma was distributed at the cervicothoracic junction in two cases,the upper thoracic segment in one case and the thoracolumbar segment in two cases;covering 3-6 segments in two cases,2-3 segments in two cases and 1 segment in one case;hematoma was located at the ventral side of the dural sac in two cases,and the dorsal side of the dural sac in three cases.Postoperative pathology showed that one case was simple blood clot,and two cases were blood clot with a large number of neutrophil infiltration.One case was hyperacute phase with isointensity on T1WI and high signal on T2WI,three cases were acute phase with isointensity on T1WI and low signal on T2WI,and one case was subacute phase with high signal on T1WI and low signal on T2WI.Enhanced scanning showed that one case was uneven enhancement,one case was irregular edge enhancement and three cases had no obvious enhancement.ASIA grade of two cases returned to E,one case returned to C after surgery,and lower limb muscle strength of two cases returned to E after conservative treatment,and MRI reexamination showed that the hematoma was absorbed.Conclusion MRI has strong sensitivity for the lesions of patients with spontaneous spinal subdural hematoma,which can accurately show the location and size of the hematoma,help to distinguish the progression of the disease,and has great significance for clinical diagnosis and treatment.
