๋ฉ”์ธ ์ฝ˜ํ…์ธ ๋กœ ๊ฑด๋„ˆ๋›ฐ๊ธฐ
์ฆ๋ก€ #1
1/40
ํ™˜์ž ์ •๋ณด: 47 ์„ธ, ๋‚จ์„ฑ
์ ์‘์ฆ: L1 ๋ฐฉ์ถœ ๊ณจ์ ˆ, ํ•˜์ง€ ๊ทผ๋ ฅ ์•ฝํ™”

์ฆ๋ก€ #1

์†Œ๊ฒฌ

  • ์ด ์ˆ˜์ค€์—์„œ ์‹ฌํ•œ ์ฒ™์ถ”๊ด€ ํ˜‘์ฐฉ์„ ์ดˆ๋ž˜ํ•˜๋Š” ์•ฝ 30% ๋†’์ด ์†Œ์‹ค ๋ฐ 6 mm ๊ณจ์„ฑ ํ›„๋ฐฉ ๋Œ์ถœ์„ ๋™๋ฐ˜ํ•œ ๊ธ‰์„ฑ L1 ์ถ”์ฒด ๊ณจ์ ˆ
  • L1 ๊ณจ์ ˆ์—์„œ L4 ์ƒ๋ถ€ ์ข…ํŒ ์ˆ˜์ค€๊นŒ์ง€ ํ•˜๋ฐฉ์œผ๋กœ ์—ฐ์žฅ๋˜๋Š” ๋ณต์ธก ๊ฒฝ๋ง‰์™ธ ํ˜ˆ์ข…, ์ตœ๋Œ€ 5 mm ๋‘๊ป˜๋กœ L1-L2์—์„œ ์‹ฌํ•œ ์ฒ™์ถ”๊ด€ ํ˜‘์ฐฉ, L2-L3์—์„œ ์ค‘๋“ฑ๋„ ์ฒ™์ถ”๊ด€ ํ˜‘์ฐฉ, L3-L4์—์„œ ๊ฒฝ๋„ ์ฒ™์ถ”๊ด€ ํ˜‘์ฐฉ์„ ์ดˆ๋ž˜ํ•จ
  • L1 ์ˆ˜์ค€์—์„œ ์ „๋ฐฉ ๋ฐ ํ›„๋ฐฉ ์ข…์ธ๋Œ€์˜ ๊ตญ์†Œ์  ํŒŒ์—ด ๊ฐ€๋Šฅ
  • T12-L1 ๊ทน๊ฐ„ ์ธ๋Œ€ ๋ฐ T12 ์ˆ˜์ค€์˜ ๊ทน์ƒ ์ธ๋Œ€์—์„œ ๊ตญ์†Œ์  ํŒŒ์—ด์„ ๋™๋ฐ˜ํ•œ T2/STIR ์‹ ํ˜ธ ๊ณผ๊ฐ•๋„
  • L1-L2์—์„œ ์ „์ถ”์ฒด ๋ถ€์ข…
  • T12 ๋ฐ L3 ์ถ”์ฒด ๋‚ด T1/T2/STIR ๊ณ ์‹ ํ˜ธ ๋ณ‘๋ณ€, ๋น„์ „ํ˜•์  ์ฒ™์ถ” ์ •๋งฅ ๊ธฐํ˜•(ํ˜ˆ๊ด€์ข…)์œผ๋กœ ์ถ”์ •๋จ
  • L5-S1์—์„œ ์ถ”๊ฐ„ํŒ ๊ฑด์กฐ ๋ฐ ๋†’์ด ๊ฐ์†Œ
  • L4-L5 ๋ฐ L5-S1์—์„œ ํ›„๊ด€์ ˆ ๋น„๋Œ€ ๋ฐ ํ™ฉ์ƒ‰ ์ธ๋Œ€ ๋น„ํ›„๊ฐ€ ๊ฒฝ๋„ ์–‘์ธก ์‹ ๊ฒฝ๊ณต ํ˜‘์ฐฉ์— ๊ธฐ์—ฌ
  • ์ฒ™์ˆ˜ ์›๋ฟ”์€ ์‹ ํ˜ธ ์ด์ƒ ์—†์ด ์ •์ƒ ์œ„์น˜์— ์ข…๋ฃŒ
  • L4-L5์—์„œ ๋ฏธ์„ธ ์ „๋ฐฉ ์ „์œ„์ฆ

์ง„๋‹จ

๊ฒฝ๋ง‰์™ธ ํ˜ˆ์ข…

์ธ๋Œ€ ์†์ƒ

์ƒ˜ํ”Œ ๋ณด๊ณ ์„œ

์ด ์ˆ˜์ค€์—์„œ ์‹ฌํ•œ ์ฒ™์ถ”๊ด€ ํ˜‘์ฐฉ์„ ์ดˆ๋ž˜ํ•˜๋Š” ์•ฝ 30% ๋†’์ด ์†Œ์‹ค ๋ฐ 6 mm ๊ณจ์„ฑ ํ›„๋ฐฉ ๋Œ์ถœ์„ ๋™๋ฐ˜ํ•œ ๊ธ‰์„ฑ L1 ์ถ”์ฒด ๊ณจ์ ˆ. ์ฒ™์ˆ˜ ์›๋ฟ”์˜ ์ด์ƒ ์‹ ํ˜ธ ์—†์Œ.

L1 ๊ณจ์ ˆ์—์„œ L4 ์ƒ๋ถ€ ์ข…ํŒ ์ˆ˜์ค€๊นŒ์ง€ ํ•˜๋ฐฉ์œผ๋กœ ์—ฐ์žฅ๋˜๋Š” ๋ณต์ธก ๊ฒฝ๋ง‰์™ธ ํ˜ˆ์ข…, ์ตœ๋Œ€ 5 mm ๋‘๊ป˜๋กœ L1-L2์—์„œ ์‹ฌํ•œ ์ฒ™์ถ”๊ด€ ํ˜‘์ฐฉ, L2-L3์—์„œ ์ค‘๋“ฑ๋„ ์ฒ™์ถ”๊ด€ ํ˜‘์ฐฉ, L3-L4์—์„œ ๊ฒฝ๋„ ์ฒ™์ถ”๊ด€ ํ˜‘์ฐฉ์„ ์ดˆ๋ž˜ํ•จ.

L1 ์ˆ˜์ค€์—์„œ ์ „๋ฐฉ ๋ฐ ํ›„๋ฐฉ ์ข…์ธ๋Œ€์˜ ๊ตญ์†Œ์  ํŒŒ์—ด ๊ฐ€๋Šฅ.

T12-L1์—์„œ ๊ทน๊ฐ„ ๋ฐ ๊ทน์ƒ ์ธ๋Œ€ ์†์ƒ๊ณผ T12 ๊ทน๋Œ๊ธฐ ์ธ์ ‘ ๊ทน์ƒ ์ธ๋Œ€์˜ ๊ตญ์†Œ์  ํŒŒ์—ด.

๊ณ ์ฐฐ

  • ์™ธ์ƒ ์‹œ ๊ฒฝ๋ง‰์™ธ ํ˜ˆ์ข…์„ ํ•ญ์ƒ ์ฃผ์˜ ๊นŠ๊ฒŒ ์‚ดํŽด๋ณด์‹ญ์‹œ์˜ค. ์ด๋“ค์€ ๋•Œ๋•Œ๋กœ ๊ณจ์ ˆ ์ž์ฒด๋ณด๋‹ค ๋” ์ฆ์ƒ์ ์ธ ์ฒ™์ˆ˜ ๋ฐ ์‹ ๊ฒฝ๊ทผ ์••๋ฐ•์„ ์ดˆ๋ž˜ํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค
  • ํ•˜๋‚˜ ์ด์ƒ์˜ ์ฃผ(column)๋ฅผ ์นจ๋ฒ”ํ•˜๋Š” ๊ณจ์ ˆ์„ ๋ณผ ๋•Œ ์ธ๋Œ€ ์†์ƒ์„ ์˜ˆ์ƒํ•˜์‹ญ์‹œ์˜ค
  • ํŠนํžˆ, ๋‹ค์Œ์œผ๋กœ ๊ตฌ์„ฑ๋œ ํ›„๋ฐฉ ์ธ๋Œ€ ๋ณตํ•ฉ์ฒด(PLC)์˜ ๋ฌด๊ฒฐ์„ฑ์„ ํ‰๊ฐ€ํ•˜์‹ญ์‹œ์˜ค:
    • ๊ทน์ƒ ์ธ๋Œ€
    • ๊ทน๊ฐ„ ์ธ๋Œ€
    • ํ›„๊ด€์ ˆ ๊ด€์ ˆ๋‚ญ
    • ํ™ฉ์ƒ‰ ์ธ๋Œ€

์ฃผ์„์ด ์žˆ๋Š” ์ด๋ฏธ์ง€ ๋ฐ ์ผ๋Ÿฌ์ŠคํŠธ

Ventral epidural collection (red arrows) that is hyperintense on T1-weighted images (left) and iso- to mildly hyperintense on T2-weighted images (right) consistent with an epidural hematoma.

Ventral epidural collection (red arrows) that is hyperintense on T1-weighted images (left) and iso- to mildly hyperintense on T2-weighted images (right) consistent with an epidural hematoma.

์ฐธ๊ณ ๋ฌธํ—Œ

  • Pierce JL, Donahue JH, Nacey NC, Quirk CR, Perry MT, Faulconer N, Falkowski GA, Maldonado MD, Shaeffer CA, Shen FH. Spinal hematomas: what a radiologist needs to know. Radiographics 2018; 38: 1516-1535.

    • ์‚ฌ์ดํŠธ ํ”ผ๋“œ๋ฐฑ

    ์—ฌ๋Ÿฌ๋ถ„์˜ ํ”ผ๋“œ๋ฐฑ์€ CaseStacks ๊ฐœ์„ ์— ๋„์›€์ด ๋ฉ๋‹ˆ๋‹ค. ์˜๊ฒฌ, ์ œ์•ˆ ๋˜๋Š” ๋ฐœ์ƒํ•œ ๋ฌธ์ œ๋ฅผ ๊ณต์œ ํ•ด ์ฃผ์„ธ์š”.

    /5
    ํ”ผ๋“œ๋ฐฑ์„ ๋ณด๋‚ด์ฃผ์…”์„œ ๊ฐ์‚ฌํ•ฉ๋‹ˆ๋‹ค. ์†Œ์ค‘ํžˆ ๋ฐ˜์˜ํ•˜๊ฒ ์Šต๋‹ˆ๋‹ค.