Spinal MR Findings in Continuous Epidural Analgesia without Infection
Ichiro Ikushimaa,
Toshinori Hiraic,
Yukunori Korogid,
Maeda Norioc,
Mikako Koganemarub,
Ryoko Sugab,
Shoji Morishitac and
Yasuyuki Yamashitac
a Department of Radiology, Miyakonojo Medical Association Hospital, Kitakyushu, Japan
b Department of Anesthesiology, Miyakonojo Medical Association Hospital, Kitakyushu, Japan
c Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kitakyushu, Japan
d Department of Radiology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan
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FIG 1. Case 3. A 57-year-old woman who received epidural anesthesia and underwent MR imaging at 3 days (A–D) and 6 weeks (E and F) after the epidural catheter was removed.
A, Fat-suppressed T2-weighted fast SE image shows a lesion in the posterior epidural space from T12 to L1 (arrow) that is isointense relative to CSF. Lesion has some hypointense areas (arrowheads).
B, On T1-weighted SE images, the lesion (arrow) is relatively hyperintense relative to CSF.
C and D, On sagittal (C) and axial (D) fat-suppressed enhanced T1-weighted images, the lesion (arrow) is homogeneously enhancing.
E and F, T2-weighted fast SE (E) and enhanced T1-weighted (F) images do not show the epidural lesion.
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FIG 2. Case 2. A 66-year-old man who received epidural anesthesia and underwent MR imaging 2 days (A and B), 2 months (C and D), and 5 months (E and F) after the epidural catheter was removed.
A, On this fat-suppressed T2-weighted fast SE image, lesion in the posterior epidural space from C3 to T1 (arrows) is isointense relative to CSF. Fresh compression fracture of the C6 and C7 vertebral bodies is hyperintense.
B, On this sagittal fat-suppressed enhanced T1-weighted image, lesion in the posterior epidural space from C1 to T1 (arrows) is inhomogeneously enhancing.
C, Although the signal intensity of the lesion has not changed on this fat-suppressed T2-weighted fast SE image, its extent is reduced, now extending from C5 to T1 (arrows). Epidural lesion has a hypointense area (arrowhead).
D, On this fat-suppressed enhanced T1-weighted image, lesion (arrows) has decreased in size and is enhanced homogeneously.
E and F, Fat-suppressed T2-weighted fast SE (E) and fat-suppressed enhanced T1-weighted (F) images do not clearly depict the lesion.
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