Contrast Enhancement Patterns of Acute Spinal Epidural Hematomas: A Report of Two Cases
Feng-Chi Changa,b,
Jiing-Feng Lirnga,b,
Shing-Su Chena,b,
Chao-Bao Luoa,b,
Wan-You Guoa,b,
Michael Mu Huo Tenga,b and
Cheng-Yen Changa,b
a Departments of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
b National Yang Ming University, School of Medicine, Taipei, Taiwan, R.O.C.
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FIG 1. Case 1, a 69-year-old woman. MR images of the thoracolumbar spine, obtained 10 hours after sudden-onset severe back pain, show a large SEH in the dorsal area of T9–L3.
A, Sagittal T2-weighted (2000/80/2 [TR/TE/NEX]) image shows the hematoma as a heterogeneously hyperintense area (arrows).
B, Sagittal T1-weighted (400/20/2) image of the lumbar spine shows an isointense hematoma (arrowheads).
C, Contrast-enhanced sagittal T1-weighted image (400/20/2) shows an enhanced area (arrows) within the hematoma (arrowheads) at the level of T12.
D, Axial T1-weighted image (400/20/2), at the level of T12, shows an isointense hematoma (arrowheads).
E, Contrast-enhanced axial T1-weighted image (400/20/2), at the level of T12, shows an enhanced area (arrow) within the hematoma (arrowheads).
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FIG 2. Case 2, an 82-year-old man. MR images of the cervical spine, obtained 4 hours after a fall, reveal a large SEH in the dorsal area of C5–C7.
A, Sagittal T2-weighted (2000/80/2) image shows a hyperintense epidural hematoma (arrowheads). A hypointense displaced dura (arrows) indicates the epidural location of the hematoma.
B, Sagittal proton density-weighted (2000/20/2) image shows a slightly hyperintense SEH (arrowheads).
C, Sagittal T1-weighted (400/20/2) image reveals the isointense SEH (arrowheads).
D, Contrast-enhanced sagittal T1-weighted (400/20/2) image shows multiple, enhanced spots (arrow) within the hematoma (arrowheads).
E, Contrast-enhanced axial T1-weighted (400/20/2) image shows spotty enhancement (arrows) at the level of C6.
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