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论著-头颈部

放射性脑损伤的MRI及灌注成像分析

作者:杨 宇 黄艳芳 周智慧 李 平

所属单位:湖南中医学院第一附属医院放射科(湖南 长沙 410007)

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摘要

目的 探讨放射性脑损伤的影像 特征。方法 回顾分析我院环形强化放射 性脑损伤病例31例,按环开闭情况、环的 张力和形态演变、ASL-CBF灌注、DWI信号 分析。结果 ①4例呈闭环有张力;23例 呈闭环无张力;4例呈开环。②低灌注26 例;等灌注1例;边缘高灌注4例;③随时 间延长:环缩小的17例,增大的11例,不 变的3例;环形态不变的9例,变化的22 例;④DWI信号:11例高信号位于环内, 17例环形高信号,3例呈片状高信号。结 论 放射性脑损伤CBF多呈低灌注;脑外病 变放疗导致的放射性脑损伤DWI高信号位 于强化环内、强化环可逐渐增大但形态保 持不变。

Objective To discuss the imaging features of radiation-induced brain injury. Methods A retrospective analysis of 31 cases of radiation-induced brain injury in our hospital has been carried out. The MRI features were analyzed according to the open and closed ring, the tension and morphology changes of the ring,ASL-CBF perfusion and the DWI signal analysis. Results ①4 cases showed closed ring with tension. 23 cases with closed loop ring with no tension, 4 cases with open ring. ②26 cases presented low perfusion, perfusion in 1 case and edge part high perfusion in 4 cases. ③Rings of 17 cases reduced with time while 11 enlarged and 3 cases had no change. Besides,9 cases had no morphological changes while 22 cases had. ④DWI signal:high signal of 11 cases is located in the inner ring, 17 cases showed high signal and 3 cases were like patchy high signal. Conclusion The CBF present low perfusion in MRI mostly; The brain damage caused by brain external lesions showed the DWI high signal is located in the inner enhancement ring, it can increased with time, but the shape didn't change.

【关键词】放射性脑损伤;环形强化;灌注成像

【中图分类号】R651.1+5

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2016.06.001

前言

头颈部肿瘤放射治疗后出现放射性脑损伤的几率很大,本文结合 我院病例对其常规MRI表现和ASL(动脉自旋标记)灌注成像的进行探 讨。