Radiation-Induced Delayed Extensive Brain Hyperintensity Lesions on MR Imaging: A Case Report
Abstract: Background: treatment with radiation therapy for cranial tumors can cause focal and diffuse cere-bral white matter injury. However, the literature rarely describes a radiation-induced delayed extensive cere-bral injury. Our objective was to report a rare case that had a delayed extensive hyperintensity injury in brain on MRI after radiation therapy due to nasopharyngeal cancer. Methods: a MRI was performed on a 40-year-old patient with extensive brain damage who had the radiation therapy two years ago.MRI results were analyzed visually. Results: on MRI, T2-weighted MRI showed an extensive hyperintensity after treated by irradiation. The radiographic pattern of extensive cerebral injury is relatively distinct. It involves the white matter and gray matter in cerebral, cerebellum, medulla oblongata, pons, intrnal capsule and thalamus bilaterally. Conclusions: our observations demonstrate that the extensive hyperintensity lesions in brain on MRI after radiation therapy are a rare radioactive delayed encephalopathy.
文章引用: 周业庭 , 童道明 (2011) 放射诱导迟发性广泛性脑MRI高信号损害一例报告。 临床医学进展， 1， 27-29. doi: 10.12677/acm.2011.12006
 Y. X. Wang, A. D. King, H. Zhou, et al. Evolution of radia-tion-induced brain injury: MR imaging-based study. Radiology, 2010, 254(1): 210-218.
 J. S. Tsuruda, K. E. Kortman, W. G. Bradley, et al. Radiation effects on cerebral white matter: MR evaluation. American Journal of Roentgenology, 1987; 149(1): 165-171.
 Y. I. Chan, S. F. Leung, A. D. King, et al. Late radiation injury to the temporal lobes: Morphologic evaluation at MR imaging. Radiology, 1999, 213(3): 800-807.
 A. Asai, K. Kawamoto. Radiation-induced brain injury. Brain Nerve, 2008, 60(2): 123-129.
 P. L. Khong, D. L. Kwong, G. C. Chan, et al. Diffusion-tensor imaging for the detection and quantification of treatment-Induced white matter injury in children with medulloblastoma: A pilot study. American Journal of Neuroradiology, 2003, 24(4): 734-740.
 S. Wang, E. X. Wu, D. Qiu, et al. Longitudinal diffusion tensor magnetic resonance imaging study of radiation-induced white matter damage in a rat model. Cancer Research, 2009, 69(3): 1190-1198.
 P. E. Valk, W. P. Dillon. Radiation injury of the brain. American Journal of Neuroradiology, 1991, 12(1): 45-62.
 M. Becker, G. Schroth, P. Zbären, et al. Long-term changes induced by high-dose irradiation of the head and neck region: Imaging findings. Radiographics, 1997, 17(1): 5-26.
 A. Muthukrishnan, M. Bajoghli, and J. M. Mountz. Delayed development of radiation vasculopathy of the brain stem confirmed by F-18 FDG PET in a case of anaplastic astrocytoma. Clinical Nuclear Medicine, 2007, 32(7): 527-531.
 K. Sano, K. Morii, M. Sato, et al. Radiation-induced diffuse brain injury in the neonatal rat model—Radiation-induced apoptosis of oligodendrocytes. Neurologia Medico-Chirurgica (Tokyo), 2000, 40(10): 495-499.
 M. C. Vigliani, C. Duyckaerts, J. J. Hauw, et al. Dementia following treatment of brain tumors with radiotherapy administered alone or in combination with nitrosourea-based chemotherapy: A clinical and pathological study. Journal of Neuro-Oncology, 1999, 41(2): 137-149.