Evaluation of treatment-induced cerebral white matter injury by using diffusion-tensor MR imaging: initial experience.
Evaluation of treatment-induced cerebral white matter injury by using diffusion-tensor MR imaging: initial experience.
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发表时间：
2005-10
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通讯作者：
Sawako Kitahara;S. Nakasu;K. Murata;K. Sho;R. Ito
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作者：
Sawako Kitahara;S. Nakasu;K. Murata;K. Sho;R. Ito
背景与目的脑肿瘤的化疗和放射治疗可引起脑白质损伤。然而，传统的磁共振成像并不总是描述治疗引起的一过性WM异常。我们研究了弥散张量(DT)磁共振成像和质子磁共振波谱检测正常白质内治疗诱导的瞬时变化的能力。方法对8例接受手术、化疗和放射治疗的脑肿瘤患者(共17次)和11例年龄匹配的对照组进行DT磁共振成像和质子磁共振波谱检查。测量27个WM正常大脑半球的表观扩散系数(ADC)、各向异性分数(FA)和N-乙酰天门冬氨酸(NAA)/肌酸(Cr)比值。根据放射治疗结束后的时间段，我们将各向同性ADC、FA和NAA/Cr数据集分为4组：组1(0-2个月；n=10)、组2(3-5个月；n=5)、组3(6-9个月；n=7)和组4(10-12个月；n=5)。用t检验比较各组平均各向同性ADC、平均FA和NAA/Cr的平均值。结果与对照组比较，组2的平均FA、NAA/Cr值降低，平均同位素ADC值升高(P值分别为0.004、0.04、0.0085)。对照组与患者1、3、4组的平均值无显著差异。结论DT磁共振成像和质子磁共振波谱可提供定量指标，可反映治疗引起的正常西医的一过性紊乱。
BACKGROUND AND PURPOSE Treatment with chemotherapy and radiation therapy for brain tumors can cause white matter (WM) injury. Conventional MR imaging, however, cannot always depict treatment-induced transient WM abnormalities. We investigated the ability of diffusion-tensor (DT) MR imaging and proton MR spectroscopy to detect the treatment-induced transient changes within normal-appearing WM. METHODS DT MR imaging and proton MR spectroscopy were performed in 8 patients treated with a combination of surgery, chemotherapy, and radiation therapy for brain tumors (17 examinations) and 11 age-matched controls. Apparent diffusion coefficient (ADC) value, fractional anisotropy (FA) value, and N-acetylaspartate (NAA)/creatine (Cr) ratio were obtained from 27 hemispheres with normal-appearing WM in the patients. We divided the datasets of isotropic ADC, FA, and NAA/Cr, on the basis of the time period after completion of radiation therapy, into 4 groups: group 1 (0-2 months; n = 10), group 2 (3-5 months; n = 5), group 3 (6-9 months; n = 7), and group 4 (10-12 months; n = 5). We compared averages of mean isotropic ADC, mean FA, and NAA/Cr of each patient group with those of the control group by using a t test. RESULTS In the group 2, averages of mean FA and NAA/Cr decreased and average of mean isotopic ADC increased in comparison with those of the control group (P = .004, .04, and .0085, respectively). There were no significant differences in the averages between the control group and patient groups 1, 3, and 4. CONCLUSION DT MR imaging and proton MR spectroscopy can provide quantitative indices that may reflect treatment-induced transient derangement of normal-appearing WM.