Purpose

Posterior spinal epidural space (PSES) is a fat-containing space. We noted numerous spinal MRIs demonstrating T2-hyperintense thickening of the cervical/thoracic PSES in early newborns, resembling epidural edema. Our aim is to describe the appearance/frequency of this finding and explore any associations with delivery.

Methods

Retrospectively, 202 spinal/cranial MRIs, belonging to newborns within the first 2 weeks of life, were evaluated using sagittal fat-suppressed T2, T1-FLAIR, and STIR. Exclusion criteria were motion, incomplete spine imaging, lack of sagittal T2/STIR, and inadequate clinical data. Ninety-three patients were included in the final analysis. We reviewed all cases for T2 hyperintense thickened PSES and, if present, accompanying abnormal T1 signal. The spinal canal and PSES thickness were measured. Clinical and demographic data were collected. Follow-up exams were evaluated, if available. Cases with thickened PSES and without were compared.

Results

T2-hyperintense thickened PSES was present in 60/93 (64.5%). Mean PSES thickness was 2.3 mm (0.7–4.6). The mean PSES thickness/spinal canal diameter ratio was 0.2 (0.1–0.5). No cord compression was identified. One had a hyperintense T1 PSES signal, compatible with epidural hemorrhage. No difference was found between those with thickened PSES and without, regarding sex, gestational age, birth weight, birth method, difficult delivery, fetal position, or neurologic status (p>0.05). Follow-up imaging was available in 10, with complete resolution of T2 hyperintense PSES thickening.

Conclusion

T2 hyperintense PSES thickening is common in imaged newborns and reversible at follow-up. No significant neurologic outcomes were found related to its presence; thus, follow-up does not appear necessary.

中文翻译：

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新生儿常见但未描述的 MRI 发现：颈椎和上胸椎硬膜外后间隙水肿

目的

后脊髓硬膜外腔 (PSES) 是一个含有脂肪的空间。我们注意到许多脊柱 MRI 显示早期新生儿颈部/胸部 PSES 的 T2 高信号增厚，类似于硬膜外水肿。我们的目的是描述这一发现的出现/频率，并探索与分娩的任何关联。

方法

回顾性地，使用矢状脂肪抑制 T2、T1-FLAIR 和 STIR 评估了 202 例脊柱/颅 MRI，属于出生后头 2 周内的新生儿。排除标准是运动、不完整的脊柱成像、缺乏矢状 T2/STIR 和临床数据不足。最终分析包括 93 名患者。我们回顾了所有 T2 高信号增厚 PSES 病例，如果存在，则伴有异常 T1 信号。测量椎管和 PSES 厚度。收集临床和人口统计数据。如果有的话，对后续检查进行了评估。比较了增厚 PSES 和没有增厚 PSES 的病例。

结果

T2 高信号增厚 PSES 存在于 60/93 (64.5%)。平均 PSES 厚度为 2.3 mm (0.7–4.6)。平均 PSES 厚度/椎管直径比为 0.2 (0.1-0.5)。未发现脐带受压。一个具有高信号 T1 PSES 信号，与硬膜外出血相符。在性别、胎龄、出生体重、分娩方式、难产、胎位或神经系统状态方面，PSES增厚组与非增厚组无差异（p> 0.05）。10 例可进行后续影像学检查，完全解决 T2 高信号 PSES 增厚。

结论

T2 高信号 PSES 增厚在成像的新生儿中很常见，并且在随访中是可逆的。没有发现与其存在相关的显着神经系统结果；因此，似乎没有必要采取后续行动。