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鼻咽癌放射治疗后脑干放射性损伤的MRI表现 被引量:21

MRI findings of radiation encephalopathy of brain stem after radiotherapy for nasopharyngeal cancer
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摘要 目的探讨鼻咽癌放射治疗后脑干放射性损伤的MRI表现。方法分析51例鼻咽癌经放射治疗后,脑干放射性损伤的MRI自旋回波T1WI及超快速自旋回波T2WI和增强后T1WI表现及临床表现。结果脑干放射性损伤的临床表现为肢体麻木、无力或瘫痪及颅神经损伤症状。MRI显示中脑、脑桥和延髓内呈斑片状改变分别为2、7及3例;脑桥基底部广泛受累9例;脑桥基底部下份及延髓前上份者30例。自旋回波T1WI病灶均呈低或等信号改变;超快速自旋回波T2WI呈等、高信号混杂改变,脑桥水平病灶内高信号呈横行条纹状。增强后扫描显示病灶区无强化者9例,斑点状强化者3例及不规则花环状强化者39例。占位效应与病灶的大小不相称。14例经治疗后MRI复查,4例病灶消失,8例病灶形态及位置无变化,2例病灶增大。结论MRI可显示脑干放射性脑病特征; Purpose To study MRI findings and clinical manifestation of radiation encephalopathy (RE) of brain stem. Methods MRI findings and clinical symptoms in 51 patients with RE of brain stem after radiotherapy for nasopharyngeal cancer were reviewed. Results Clinical symptoms included number weakness or paralysis in the limbs and symptoms of damaged cranial nerves. All lesions appeared hypo or isointense on spin echo(SE) T1weighted images and inhomogeneous and mixed hyper and isointense on Turbo spin echo(TSE) T2weighted images. The lesions were located in mesencephalon, pons, medulla, basilar part of pons, basilar part of pons and medulla oblongate in 2, 7, 3, 9 and 30 patients respectively. The enhancement patterns included irregular rings in 39 patients, spotty in 3 and no enhancement in 9 patients. Mass effect was minimal in all patients. On followup MRI, the lesions disappeared in 4 patients, did not change in size and shape in 8 patients and enlarged in 2 patients. Conclusion MRI could demonstrate the characteristic findings of RE of brain stem. MRI findings sometimes are not consistent with the clinical symptoms.
出处 《中华放射学杂志》 CAS CSCD 北大核心 1998年第8期533-536,共4页 Chinese Journal of Radiology
关键词 鼻咽肿瘤 放射疗法 脑干损伤 辐射损伤 MRI Brain stem Radiation injuries Nasopharyngeal neoplasms Magnetic resonance imaging Radiotherapy
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参考文献6

  • 1Hu J Q,J Comput Assist Tomogr,1991年,15卷,181页
  • 2李岩,临床放射学杂志,1991年,10卷,265页
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