Michelle L. Melany

A thoracolumbar epidural hematoma simulating a disc syndrome

Epidural hematoma, a rare entity, may occur spontaneously, although a factor such as anticoagulation therapy is more frequently the cause. Epidural hematomas most commonly manifest with pain and neurologic deficit. Only six cases of lumbar hematoma simulating a herniated disc syndrome have been reported in the literature. In this article a thorough knowledge of the natural history and the differential diagnosis of disc disease as well as the importance of a complete physical examination are emphasized. Sagittal MRI imaging, as shown here, has proved to be an important adjunct in the evaluation of multilevel spinal disorders.

Vascular Imaging with Sonographic Contrast Agents

Contrast agents are used extensively in vascular imaging and are an essential part of most radiographic examinations such as angiography, computed tomography (CT) and magnetic resonance imaging (MRI). In general, contrast agents change a specific property of an organ with regard to its surrounding tissues thereby increasing the signal-to-noise ratio of blood and allowing improved imaging of a targeted vessel. The exact method by which this improved imaging is accomplished depends upon the type of examination being performed. With examinations such as upper gastrointestinal series, intravenous urography or CT scans, contrast is used to increase the density of a specific organ system or vessel relative to the surrounding tissues. Therefore, high molecular weight elements such as barium or iodine are ingested or injected into the body.