MRI IN TUMORAL INFECTIOUS AND SPONTANEOUS HEMORRHAGIC EPIDURAL PATHOLOGY

Several studies [1, 2, 3, 4, 5, 6] have served to underline the intere st of MRI in the diagnosis and assessment of epidural abscess and mali gnant extradural spinal tumors. In our work, one of the quantitatively greatest published to this day, 64 patients presenting epidural patho logy were evaluated by means of MRI. All the explorations were brought about through weighted multiplaned sequences Tl, T2 and gadolinium in jection. The pathological spectrum encountered is comprised of: metast atic extradural spinal tumors (58%), primary extradural spinal tumors (7%), epidural localizations of hematological diseases (9%), epidural abscess (25%), and one case of epidural hematoma. Assessment was broug ht to bear upon behavior in relation to type of sequence, spread of di sease, medullary effects, type of enhancement following gadolinium inj ection. Degree of correlation with clinical data and surgical findings was also appraised. As concerns tumorous epidural pathology, positive diagnosis due to a lesion hinges upon the T1 and T2 sequences. Gadoli nium's contribution is restricted to analysis of perivertebral and ver tebral spreading; it also facilitates recognition of the spinal cord i n circonferential epiduritis. So much said, gadolinium appears to be e ssential in frequently less compressive forms of infectious epiduritis ; it plays a pronounced role in both follow-up of their evolution and recognition of acute epidural hematomae.