【摘要】 目的探讨鼻咽癌放射治疗后脑干放射性损伤的ＭＲＩ表现。方法分析５１例鼻咽癌经放射治疗后，脑干放射性损伤的ＭＲＩ自旋回波Ｔ１ＷＩ及超快速自旋回波Ｔ２ＷＩ和增强后Ｔ１ＷＩ表现及临床表现。结果脑干放射性损伤的临床表现为肢体麻木、无力或瘫痪及颅神经损伤症状。ＭＲＩ显示中脑、脑桥和延髓内呈斑片状改变分别为２、７及３例；脑桥基底部广泛受累９例；脑桥基底部下份及延髓前上份者３０例。自旋回波Ｔ１ＷＩ病灶均呈低或等信号改变；超快速自旋回波Ｔ２ＷＩ呈等、高信号混杂改变，脑桥水平病灶内高信号呈横行条纹状。增强后扫描显示病灶区无强化者９例，斑点状强化者３例及不规则花环状强化者３９例。占位效应与病灶的大小不相称。１４例经治疗后ＭＲＩ复查，４例病灶消失，８例病灶形态及位置无变化，２例病灶增大。结论ＭＲＩ可显示脑干放射性脑病特征；临床症状与ＭＲＩ追踪表现可不完全一致更多还原

【Abstract】 Purpose To study MRI findings and clinical manifestation of radiation encephalopathy (RE) of brain stem. Methods MRI findings and clinical symptoms in 51 patients with RE of brain stem after radiotherapy for nasopharyngeal cancer were reviewed. Results Clinical symptoms included number weakness or paralysis in the limbs and symptoms of damaged cranial nerves. All lesions appeared hypo or isointense on spin echo(SE) T1weighted images and inhomogeneous and mixed hyper and isointense on Turbo spin echo(TSE) T2weighted images. The lesions were located in mesencephalon, pons, medulla, basilar part of pons, basilar part of pons and medulla oblongate in 2, 7, 3, 9 and 30 patients respectively. The enhancement patterns included irregular rings in 39 patients, spotty in 3 and no enhancement in 9 patients. Mass effect was minimal in all patients. On followup MRI, the lesions disappeared in 4 patients, did not change in size and shape in 8 patients and enlarged in 2 patients. Conclusion MRI could demonstrate the characteristic findings of RE of brain stem. MRI findings sometimes are not consistent with the clinical symptoms.更多还原