放射性脑脊髓坏死的CT和MRI诊断  

CT and MRI Diagnosis of Radiation Myeloencephalic Necrosis

作　　者：俞高龙[1] 陈建甬[1] 楼晓剑[1] 宋永浩[2] 

机构地区：[1]解放军第113医院放射科,浙江宁波315040 [2]解放军第113医院放疗科,浙江宁波315040

出　　处：《实用放射学杂志》2010年第9期1237-1239,1253,共4页Journal of Practical Radiology

摘　　要：目的 研究及评价放射性脑脊髓坏死（radiation myeloencephalic necrosis, RMEN） 的CT和MRI表现及其诊断价值.方法 对27例经临床、CT和MRI诊断后随访确诊的RMEM病例进行分析,其中5例经手术病理证实. 结果 27例 RMEN中, 放射性脑坏死（radiation encephalic necrosis,REN ）22例,分别位于两侧颞叶12例,同侧颞叶6例,脑干损伤2例,同侧颞、顶叶2例 放射性脊髓坏死（ radiation myeloencephalic necrosis,RMN ）5例,分别位于颈段4例,胸段1例.其CT和MRI共同特征为： 主要累及白质,CT平扫显示低密度,MRI显示稍长T1和稍长T2信号改变,增强后病灶均显示不同程度强化、中心坏死后无强化,病灶周围水肿明显时有占位效应.结论 回顾27例RMEN的CT和MRI表现具有一定特征,结合放疗史,绝大部分病例可明确诊断.Objective To evaluate CT and MRI findings and the diagnostic value in radiation myeloencephalic necrosis（RMEN）. Methods Twenty--seven cases with RMEN diagnosed by following--up clinically included in this study,of them,5 cases were confirmed by pathology. CT/MRI findings were retrospectively analyzed. Results Among 27 cases,22 were radiation encephalic necrosis （REN）, the lesions located in bilateral temporal lobes in 12 cases,ipsilateral temporal lobe in 6 cases,brain stem in 2 cases and ipsi- lateral temporoparietal lobes in 2 cases. 5 cases were radiation myeloencephalic necrosis （RMN） ,the lesions located in cervical and thoracic cord in 4 and one case respectively,and the lesions were mainly located in the white matter and were low density on CT,hypodense on T1 W1 and hyperdense on T2 WI. On contrast--enhanced scan, the lesions were enhanced in different degree, but not at the centre of necrostic area. The mass effect was present when edema around the lesions presented. Conclusion Most cases of RMEN can be diagnosed correctly based on CT and MRI characteristic findings in combination with radiation history.

关 键 词：辐射损伤 脑 脊髓 体层摄影术 X线计算机 磁共振成像 

分 类 号：R744[医药卫生—神经病学与精神病学] R818[医药卫生—临床医学]