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

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。

Abstract: 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.