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中国癌症防治杂志

中国癌症防治杂志 ›› 2011, Vol. 3 ›› Issue (3): 232-235.doi: 10.3969/j.issn.1674-5671.2011.03.14

• 临床研究 • 上一篇    下一篇

鼻咽癌放疗后放射性脑干损伤的MRI表现

刘敏, 梁世雄, 廖锦元, 金观桥   

  1. 1广西医科大学研究生学院；2广西医科大学附属肿瘤医院；3广西医科大学第一附属医院
  • 出版日期:2011-09-25 发布日期:2011-10-17
  • 通讯作者: 梁世雄 E-mail:shixliang@vip.sina.com

Magnetic resonance imaging manifestations of radiation-induced brainstem injury in patients with nasopharyngeal carcinoma after radiotherapy

LIU Min, LIANG Shi-Xiong, LIAO Jin-Yuan, JIN Guan-Qiao   

  • Online:2011-09-25 Published:2011-10-17

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被引次数

2

摘要： 目的 分析鼻咽癌患者放疗后发生放射性脑干损伤的MRI表现特征。方法 对37例鼻咽癌放疗后发生放射性脑干损伤患者的MRI资料进行复阅，对MRI检查序列包括T1WI、T2WI、FLAIR以及增强扫描序列进行分析，明确放射性脑干损伤的病变部位、范围、信号强度和增强后病灶强化等的形态。结果 37例放射性脑干损伤患者，病变位于脑桥19例，中脑1例，延髓3例，脑桥+中脑6例，脑桥+延髓5例，中脑+脑桥+延髓3例。病灶在MRI上T1WI表现为等信号或低信号，T2WI表现为高信号，FLAIR表现为低、高混杂信号，增强后无明显强化者9例，强化者28例。强化方式：均匀斑片状强化者12例、不均匀环形强化者16例。结论 MRI可以清晰地显示放射性脑干损伤的病灶，MRI对于诊断放射性脑干损伤有着重要价值，为临床治疗提供参考。

关键词: 鼻咽癌, 放射性损伤, 脑干, MRI

Abstract:   Objective To analyze the magnetic resonance imaging (MRI) manifestation characteristics of radiation-induced brainstem injury in patients with nasopharyngeal carcinoma (NPC) after radiotherapy.Methods Brain MRIs from 37 patients with NPC who developed radiation-induced brainstem injury after radiotherapy were reviewed.The study analyzed imaging sequences included T1-weighted image (T1WI)，T2-weighted image (T2WI)，fluid attenuated inversion recovery (FLAIR) and enhanced scanning imaging to define the site，range，signal strength and enhanced form of the lesions with radiation-induced brainstem injury. Results Among the 37 patients，19 had lesions in pons; 1 in midbrain; 3 in medulla oblongata; 6 in pons and midbrain; 5 in pons and medulla oblongata; 3 in pons，midbrain and medulla oblongata. All lesions showed hypo-or iso-intense signal on T1WI，and hyper-intense signal on T2WI.With contrast enhanced scanning，9 cases did not show enhancement，28 cases showed marked enhancement which included 12 cases with homogenous patchy enhancement and 16 cases with heterogeneous ringed and patchy enhancement. Conclusion MRI can clearly show the lesions of radiation-induced brainstem injury in NPC patients after radiotherapy，which is available for clinical diagnosis.

Key words: Nasopharyngeal carcinoma (NPC), Radiation injury, Brainstem, Magnetic resonance imaging (MRI)