Article Figures & Data
Figures
- 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.
- 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.
Tables
Patient/Age (y)/Sex Reason for MR Imaging Interval (d) Catheter Culture Symptoms to Catheter Removal Catheter Removal to MR Imaging 1/26/F Catheter dysfunction* 1 3 Negative 2/66/M Catheter dysfunction* 1 2 Negative 3/57/F Fever 4 3 Negative 4/70/F Lower back pain 2 7 Not done 5/52/F Follow-up Not applicable 0.125 Not done * Difficulty in the continuous injection of bupivacaine through the catheter.
Patient Level of Catheter Insertion Location Extent Signal Intensity Contrast Enhancement T1 Weighted* T2 Weighted† 1 T4-5 Posterior T2-6 Hypointense Isointense Homogeneous 2 C3-4 Posterior C1-T1 Hypointense Isointense Inhomogeneous 3 T12-L1 Posterior T12-L1 Hypointense Isointense Relatively homogeneous 4 T6-7 Posterior T5-8 Hypointense Isointense Homogeneous 5 T5-6 Posterior T4-8 Hypointense Isointense Homogeneous * Relative to the spinal cord.
† Relative to CSF.
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