摘要
背景与目的:鼻咽癌(nasopharyngealcarcinoma,NPC)放疗后放射性脑病(radiation-inducedencephalopathy,REP)的影像学表现国内外报道较多,而磁共振脑血流灌注检查(magneticresonanceperfusionweightedimaging,MRPWI)作为一种新的检查技术,目前国内外已逐渐应用于临床REP的研究。本研究拟观察鼻咽癌迟发性REP的MRPWI表现特征,探讨其对REP的诊断价值。方法:对26例正常志愿者52个颞叶及MRI诊断为颞叶REP的19例病例共37个病灶的MRPWI资料进行回顾性分析。鼻咽癌患者放射治疗后30个月～9年进行MRI检查,成像序列包括T1WI、T2WI、MRPWI、Gd-DTPAT1WI增强。结果:19例REP中累及单侧颞叶1例,双侧颞叶18例,共37个病灶。MRPWI发现REP病变水肿区相对脑血流容积和相对脑血流量均降低,平均通过时间、峰值时间、到达时间均延长;血脑屏障破坏区相对脑血流容积、相对脑血流量与正常组无显著性差异,平均通过时间、峰值时间、到达时间均延长。脑白质坏死囊性变未见脑血流灌注。结论:MRPWI可正确反映REP各种病变的脑血流灌注特点,显示REP中存在明显的脑血流灌注障碍。
BACKGROUND ＆ OBJECTIVE. The imaging appearances of radiation-induced encephalopathy （REP） of nasopharyngeal carcinoma （NPC） patients were widely reported. As a new technique, magnetic resonance peffusion weighted imaging （MR PWI） is gradually applied to clinical study of REP. This study was designed to observe the characteristics of REP of NPC patients on MR PWI, and investigate its diagnostic value. METHODS. The MRI and MR PWI records of 26 volunteers and 19 NPC patients with 37 lesions of MRI-diagnosed temporal lobe REP were retrospectively analyzed. The MRI was performed 30 months to 9 years after radiation therapy for NPC. The imaging sequences included T1-weighted imaging （T1WI）, T2-weighted imaging （T2WI）, MR PWI, and Gd-DTPA- contrasted T1WI. RESULTS： Unilateral temporal lobe was involved in 1 case of REP, and bilateral temporal lobes in 18 cases of REP. MR PWI revealed that in edema areas of REP, relative cerebral blood volume （rCBV） and relative cerebral blood flood （rCBF） were decreased, mean transit time （MTT）, time to peak （TTP）, and time of arrival （TO） were delayed simultaneously; in demolished blood-brain barrier areas of REP, rCBV and rCBF were normal, but MTT,TTP, and TO were delayed; no blood perfusion was observed in myelinopathy areas of REP. CONCLUSION： MR PWI can clearly reveal brain blood perfusion changes in various lesions of REP, and indicate that obvious malfunction of brain blood perfusion is occurred in REP.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2005年第9期1102-1105,共4页
Chinese Journal of Cancer
关键词
鼻咽肿瘤/放射疗法
脑放射性损伤/辐射效应
磁共振成像
脑血流灌注
诊断
Nasopharyngeal neoplasms/radiotherapy
Radiation-induced encephalopathy/radiant effect
Magnetic resonance imaging
Diagnosis
作者简介
通讯作者：赵继泉，Tel：86—757—8332950 Fax：86—20—81332702 E-mail：fstomz@21cn．com 现工作单位为佛山第二人民医院MR室（邮政编码：528000）
