Preoperative MR Diagnosis of Spinal Subdural Empyema-Secondary to Osteomyelitis and Epidural Empyema

文獻中只有少數脊椎下硬腦膜膿瘍被報告，而手術前的診斷更少。本文病例為一75歲女性，為子宮頸癌患者，因為高燒不退，白血球升高且下背疼痛來求診。病患本身為糖尿病患者，於15年前接受腰椎第四節與第五節手術且併發骨髓炎。目前核磁共振影像可見腰椎第四節與第五節骨髓炎，且有上硬腦膜，下硬腦膜膿瘍。下硬腦膜膿瘍由腰椎第四節延伸到胸椎第十一節。經由椎板切除術及硬腦膜切開術證實，確實為下硬腦膜膿瘍。

關鍵字

磁振造影；骨髓炎；下硬腦膜膿瘍

並列摘要

Only few cases of spinal subdural empyema has been reported in the literature and the preoperative diagnosis is much less. Due to the advance of magnetic resonance imaging techniques, we reported a 75 years old female with spinal subdural empyema. She was a diabetic patient and received laminectomy, complicated with vertebral body osteomyelitis about 15 years ago at the 4th and 5th vertebral body of lumbar region (L4/5). She is a victim of cervical cancer and currently suffered from leukocytosis, high fever and then low back pain for several weeks. Magnetic resonance imaging clearly depicts the picture of osteomyelitis at L4/5 with mixed epidural and subdural abscess. The subdural lesion extended upwardly from L4 to T11 (the 11th vertebrae of thoracic spine) level. Laminectomy and durectomy were performed soon and clearly revealed the picture of long segment subdural abscess. Post-operation recovery course is fine.

並列關鍵字

Magnetic resonance imaging ； Osteomyelitis ； Subdural empyema

國際替代計量

Preoperative MR Diagnosis of Spinal Subdural Empyema-Secondary to Osteomyelitis and Epidural Empyema

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