鼻咽癌放疗后放射性脑病临床疗效的MRI观察

目的:探讨磁共振成像评估鼻咽癌放射治疗引起放射性脑病的临床治疗疗效。材料及方法:24例鼻咽癌放射治疗后出现放射性脑病患者,在临床治疗前后进行MRI检查。结果:MRI显示病变累及颞叶者10例,脑干部位14例。MRI SE T1加权成像病灶均呈低信号改变;T2加权成像呈等、高信号混杂改变。增强后扫描显示病灶区无强化者6例、不规则斑片状强化18例。追踪MRI显示9例病灶消失,4例临床症状缓解及5例症状消失;12例病灶大小形态无改变者中,3例临床症状经治疗后有明显好转,9例临床症状无明显变化。3例病灶增大者,临床症状无变化者1例及症状加重2例。结论:MRI可以显示放射性脑病经过临床治疗后的病灶变化,临床症状的变化与MRI所见不完全一致。

The MRI Evaluation on Treatment of Radiation Encephalopathy after Radiotherapy of Nasopharyngeal Carcinoma

Purpose: To evaluate the effects on the treatment of radiation en-cephalopathy (RE) by MRI. Materials and methods: 24 patients with RE before and after treatment were performed, with MRI. Results: The lesions located in temporal lobe (10 patients) and brain stem (14 patients), Hypointensity on SE T1 - weighted images and hyper-intensity on Turbo SE T2 - weighted images were demonstrated. The enhancement were demonstrated in 18 patients on postcontrast T1 - weighted images and no enhancement in 6 patients. The lesions disappeared in 9 patients, did not change in 12 patients and enlarged in 3 patients on follow - up MRI. Conclusion: We believe that MRI can show the characteristic findings of RE and that the findings of MRI are not in accordance with the changes of clinical manifestation.