目的:探讨放射性脑坏死(Brain radiation necrosis,BRN)的 MRI 诊断和鉴别诊断。 方法:回顾性分析 本院10 例 BRN 病人资料,所有病例均行 MRI 平扫、增强扫描、灌注成像(PWI)。 结果:这10 例病例中8 例具有 MRI 的特异性表现:T1 WI 呈低信号,T2 WI 呈高信号,信号不均匀,病灶呈不均匀明显强化,强化灶外形不规则 呈粗大齿轮状,水肿沿白质蔓延呈爪状。 磁共振灌注成像(PWI):8 例呈低灌注,2 例呈无灌注;10 例脑血容量 (rCBV)均减低。 结论:BRN 与肿瘤复发在影像表现与临床上很相似,往往不易区分,容易误诊,应综合病人病 史、发病时间、MRI 平扫、增强扫描的特异性表现,同时结合 PWI 不难鉴别。

To investigate the MRI diagnosis and differential diagnosis of BRN. Methods:The data of 10 BRN cases was reviewed. All cases had plain MRI scan and contrast enhancement scan, PWI. Results:8 cases had MRI specific performance: long T1 and long T2 with signal heterogeneous,lesions showed heterogeneous marked enhancement,strengthen shapes were bulky gear like, the edemas spread along the white matter showed a claw - like. PWI: 8 cases were hypoperfused,2 cases were nonperfused. 10 cases rCBV were all reduced. Conclusions:It is difficult to differentiate BRN from glioma recurrence. The medical history, the morbidity time, the special appearance of MRI,PWI may contribute to diagnose.

R445. 4