MRI Finding in Delayed Extensive Brain Lesions after Radiation Therapy :Cortical Laminar Necrosis and White Matter Myelinolysis
ABSTRACT
The focal and diffuse cerebral white matter injury can be caused by treatment with radiation therapy for cranial tumors. However, the literature rarely describes a MRI finding in radiation-induced delayed extensive cerebral injury. Our objective was to report a rare case who had a delayed extensive hyperintensity injury in brain on MRI after radiation therapy due to nasopharyngeal cancer. A MRI was performed on a 40-year-old patient with extensive brain damage who had the radiation therapy two years ago.MRI finding was evaluated. 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, internal capsule and thalamus bilaterally. Our observations demonstrate that the extensive hyperintensity lesions in brain on MRI after radiation therapy is a cortical laminar necrosis and white matter myelinolysis.
The focal and diffuse cerebral white matter injury can be caused by treatment with radiation therapy for cranial tumors. However, the literature rarely describes a MRI finding in radiation-induced delayed extensive cerebral injury. Our objective was to report a rare case who had a delayed extensive hyperintensity injury in brain on MRI after radiation therapy due to nasopharyngeal cancer. A MRI was performed on a 40-year-old patient with extensive brain damage who had the radiation therapy two years ago.MRI finding was evaluated. 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, internal capsule and thalamus bilaterally. Our observations demonstrate that the extensive hyperintensity lesions in brain on MRI after radiation therapy is a cortical laminar necrosis and white matter myelinolysis.
KEYWORDS
Radiation-induced brain damage, Magnetic resonance imaging, Encephalopathy，Cortical laminar necrosis, Demyelination
Radiation-induced brain damage, Magnetic resonance imaging, Encephalopathy，Cortical laminar necrosis, Demyelination
Cite this paper
Z. Ye-Ting, G. Wang, X. Chen and D. Tong, "MRI Finding in Delayed Extensive Brain Lesions after Radiation Therapy :Cortical Laminar Necrosis and White Matter Myelinolysis," Advances in Molecular Imaging, Vol. 2 No. 1, 2012, pp. 1-3. doi: 10.4236/ami.2012.21001.
Z. Ye-Ting, G. Wang, X. Chen and D. Tong, "MRI Finding in Delayed Extensive Brain Lesions after Radiation Therapy :Cortical Laminar Necrosis and White Matter Myelinolysis," Advances in Molecular Imaging, Vol. 2 No. 1, 2012, pp. 1-3. doi: 10.4236/ami.2012.21001.
References
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[1] Wang Y.X., King A.D.,and Zhou H., et al. Evolution of radiation-induced brain injury: MR imaging-based study. Radiology. 2010; 254(1):210-218. [2] Tsuruda J.S., Kortman K.E.,and Bradley W.G., et al. Radiation effects on cerebral white matter: MR evaluation. AJR Am J Roentgenol 1987;149(1):165–171. [3] Chan Y.I., Leung S.F., and King A.D., et al.Late Radiation Injury to the Temporal Lobes: Morphologic Evaluation at MR Imaging.Radiology. 1999; 213(3): 800 - 807. [4] Asai A., Kawamoto K. Radiation-induced brain injury. Brain Nerve. 2008; 60(2):123-129. [5] Khong P.L., Kwong D.L.,and Chan G.C., et al. Diffusion-Tensor Imaging for the Detection and Quantification of Treatment-Induced White Matter Injury in Children with Medulloblastoma: A Pilot Study. AJNR Am. J. Neuroradiol. 2003; 24(4): 734 - 740. [6] Wang S., Wu E.X., and Qiu D., et al. Longitudinal Diffusion Tensor Magnetic Resonance Imaging Study of Radiation-Induced White Matter Damage in a Rat Model Cancer Res. 2009; 69(3): 1190 - 1198. [7] Valk P.E., Dillon W.P. Radiation injury of the brain. AJNR. 1991; 12(1):45–62. [8] Becker M., Schroth G., and Zbaren P., et al.Long-term changes induced by high-dose irradiation of the head and neck region: imaging findings. Radiographics. 1997; 17(1):5-26. [9] Muthukrishnan A., Bajoghli M., and Mountz J.M. Delayed development of radiation vasculopathy of the brain stem confirmed by F-18 FDG PET in a case of anaplastic astrocytoma. Clin Nucl Med. 2007; 32(7):527-531. [10] Sano K., Morii K., and Sato M., et al.Radiation-induced diffuse brain injury in the neonatal rat model--radiation-induced apoptosis of oligodendrocytes. Neurol Med Chir (Tokyo). 2000;40(10):495-499. [11] Vigliani M.C., Duyckaerts C., and Hauw J.J., et al. Dementia following treatment of brain tumors with radiotherapy administered alone or in combination with nitrosourea-based chemotherapy: a clinical and pathological study.J Neurooncol. 1999; 41(2):137-149.