Morphologic magnetic resonance imaging features of therapy-induced cerebral necrosis
Morphologic magnetic resonance imaging features of therapy-induced cerebral necrosis
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DOI：
10.1007/s11060-010-0222-9
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发表时间：
2011-01-01
影响因子：
3.9
通讯作者：
Jain, R.
中科院分区：
文献类型：
--
作者：
Rogers, L. R.;Gutierrez, J.;Jain, R.
描述经组织学证实的治疗性脑坏死的形态学磁共振成像（MRI）结果。我们回顾性回顾了治疗性脑坏死患者的MRI形态学表现。检查图像的大小、位置、信号强度异常和t1对比增强的特征。影像也评估肿块效应、坏死、囊肿、萎缩、皮质变薄和脑白质病。个体影像学特征与临床和治疗变量相关。共有44例患者。70%的患者患有神经胶质瘤，所有的患者都接受过放疗，57%的患者接受过临近放疗的化疗。所有图像显示对比度增强，主要是在白质。50%的病例脑室周围/室管膜下区域增强，27%的病例胼胝体增强。病变周围增强最常见的模式是“扩张性波前”，内部增强最常见的模式是“瑞士奶酪/肥皂泡”。在60%的病例中，增强病灶是单一的。93%的患者存在质量效应。增强的位置和模式与从脑放射到诊断治疗性脑坏死的间隔、肿瘤组织学、患者年龄、放射类型和全身化疗的管理显著相关。这是病理证实的治疗性脑坏死的形态学常规MRI发现的最大研究。我们描述了各种肿瘤类型在各种放射治疗和其他抗肿瘤治疗后的影像学表现。这些发现可能对识别治疗脑肿瘤患者的治疗性脑坏死有价值。
To describe the morphologic magnetic resonance imaging (MRI) findings in histologically proven therapy-induced cerebral necrosis. We retrospectively reviewed the morphologic MRI findings in patients with therapy-induced cerebral necrosis. Images were reviewed for size, location, and characteristics of signal intensity abnormalities and T1-contrast enhancement. Images were also assessed for mass effect, necrosis, cyst, atrophy, cortical thinning, and leukoencephalopathy. The individual imaging characteristics were correlated with clinical and treatment variables. There were 44 patients. Seventy percent had a glioma, all patients had received radiation, and 57% had received chemotherapy in close proximity to radiation. All images demonstrated contrast enhancement, predominantly in the white matter. Enhancement was present in the periventricular/subependymal region in 50% of cases and the corpus callosum in 27%. The most common pattern of lesion peripheral enhancement was "spreading wavefront" and of interior enhancement was "Swiss cheese/soap bubble." The enhancing lesion was single in 60% of cases. Mass effect was present in 93% of patients. Location and patterns of enhancement were significantly associated with the interval from brain radiation to the diagnosis of therapy-induced cerebral necrosis, tumor histology, patient age, type of radiation, and administration of systemic chemotherapy. This is the largest study of the morphologic conventional MRI findings in pathologically confirmed therapy-induced cerebral necrosis. We characterized the imaging findings in a variety of tumor types following a variety of radiation treatments and other antineoplastic therapy. These findings may be of value in identifying therapy-induced cerebral necrosis in patients treated for a brain tumor.