ACM  >> Vol. 1 No. 2 (September 2011)

    放射诱导迟发性广泛性脑MRI高信号损害一例报告
    Radiation-Induced Delayed Extensive Brain Hyperintensity Lesions on MR Imaging: A Case Report

  • 全文下载: PDF(246KB) HTML   XML   PP.27-29   DOI: 10.12677/acm.2011.12006  
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作者:  

周业庭,童道明

关键词:
放射–诱导脑损害磁共振成像迟发性脑病髓鞘脱失
Radiation-Induced Brain Damage; Magnetic Resonance Imaging; Encephalopathy; Demyelination

摘要:

背景:颅内肿瘤采用放射治疗可引起局灶性和弥漫性脑白质的损害。然而,放疗诱导的迟发性广泛性大脑、小脑、脑干、内囊和丘脑损害尚少报告。我们的目的是报告一个鼻咽癌患者放疗后罕见的MRI广泛性脑的高信号损害病例。方法:我们对一个在2年前经放射治疗后的40岁病人进行了核磁共振检查,并目测和分析了T2加权平面图像异常信号。结果:在MRI,T2加权MRI显示一种放射治疗引起的迟发性广泛性高信号脑损害。这种广泛性脑损害的放射学模式是相当明显的,累及了双侧大脑、小脑、延髓、桥脑、内囊和丘脑。结论:我们的观察表明,放射治疗后患者的脑MRI的迟发性双侧大脑、小脑、延髓、桥脑、内囊和丘脑的高信号损害是一种罕见的放射性迟发性脑病。

Background: treatment with radiation therapy for cranial tumors can cause focal and diffuse cere-bral white matter injury. However, the literature rarely describes a radiation-induced delayed extensive cere-bral injury. Our objective was to report a rare case that had a delayed extensive hyperintensity injury in brain on MRI after radiation therapy due to nasopharyngeal cancer. Methods: a MRI was performed on a 40-year-old patient with extensive brain damage who had the radiation therapy two years ago.MRI results were analyzed visually. Results: on MRI, T2-weighted MRI showed an extensive hyperintensity after treated by irradiation. The radiographic pattern of extensive cerebral injury is relatively distinct. It involves the white matter and gray matter in cerebral, cerebellum, medulla oblongata, pons, intrnal capsule and thalamus bilaterally. Conclusions: our observations demonstrate that the extensive hyperintensity lesions in brain on MRI after radiation therapy are a rare radioactive delayed encephalopathy.

文章引用:
周业庭, 童道明. 放射诱导迟发性广泛性脑MRI高信号损害一例报告[J]. 临床医学进展, 2011, 1(2): 27-29. http://dx.doi.org/10.12677/acm.2011.12006

参考文献

[1] Y. X. Wang, A. D. King, H. Zhou, et al. Evolution of radia-tion-induced brain injury: MR imaging-based study. Radiology, 2010, 254(1): 210-218.
[2] J. S. Tsuruda, K. E. Kortman, W. G. Bradley, et al. Radiation effects on cerebral white matter: MR evaluation. American Journal of Roentgenology, 1987; 149(1): 165-171.
[3] Y. I. Chan, S. F. Leung, A. D. King, et al. Late radiation injury to the temporal lobes: Morphologic evaluation at MR imaging. Radiology, 1999, 213(3): 800-807.
[4] A. Asai, K. Kawamoto. Radiation-induced brain injury. Brain Nerve, 2008, 60(2): 123-129.
[5] P. L. Khong, D. L. Kwong, G. C. Chan, et al. Diffusion-tensor imaging for the detection and quantification of treatment-Induced white matter injury in children with medulloblastoma: A pilot study. American Journal of Neuroradiology, 2003, 24(4): 734-740.
[6] S. Wang, E. X. Wu, D. Qiu, et al. Longitudinal diffusion tensor magnetic resonance imaging study of radiation-induced white matter damage in a rat model. Cancer Research, 2009, 69(3): 1190-1198.
[7] P. E. Valk, W. P. Dillon. Radiation injury of the brain. American Journal of Neuroradiology, 1991, 12(1): 45-62.
[8] M. Becker, G. Schroth, P. Zbären, et al. Long-term changes induced by high-dose irradiation of the head and neck region: Imaging findings. Radiographics, 1997, 17(1): 5-26.
[9] A. Muthukrishnan, M. Bajoghli, and J. M. Mountz. Delayed development of radiation vasculopathy of the brain stem confirmed by F-18 FDG PET in a case of anaplastic astrocytoma. Clinical Nuclear Medicine, 2007, 32(7): 527-531.
[10] K. Sano, K. Morii, M. Sato, et al. Radiation-induced diffuse brain injury in the neonatal rat model—Radiation-induced apoptosis of oligodendrocytes. Neurologia Medico-Chirurgica (Tokyo), 2000, 40(10): 495-499.
[11] M. C. Vigliani, C. Duyckaerts, J. J. Hauw, et al. Dementia following treatment of brain tumors with radiotherapy administered alone or in combination with nitrosourea-based chemotherapy: A clinical and pathological study. Journal of Neuro-Oncology, 1999, 41(2): 137-149.