Document Detail


Late temporal lobe necrosis in patients with nasopharyngeal carcinoma: evaluation with combined multi-section diffusion weighted and perfusion weighted MR imaging.
MedLine Citation:
PMID:  11566238     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Late temporal lobe necrosis is a well-known and serious complication in patients with nasopharyngeal carcinoma (NPC) following radiotherapy. Owing to the close proximity to the skull base, the medial temporal lobes are inevitably included in the target volume of irradiation. Patients with NPC provide a unique opportunity in study of delay radiation effect in normal human brain. The objective of this study was to evaluate late temporal lobe radiation injury by combined multi-section diffusion weighted and perfusion weighted MR imaging. We prospectively studied 16 patients with typical clinical symptoms of late temporal lobe necrosis or other abnormalities in the temporal lobes incidentally detected by conventional MR imaging. All patients had a previous history of radiotherapy for histologically proven NPC. Conventional T1- and T2-weighted images, fast gradient echo with echo-planar diffusion-weighted and perfusion-weighted MR imaging were performed. Apparent diffusion coefficient (ADC) map and relative cerebral blood volume (rCBV) map were computed via commercially available software. MR diffusion and perfusion images were then analyzed and graded by two independent observers with focusing on the diffusion and perfusion mismatch. The temporal lobe lesions displayed marked high diffusion on the ADC map. The rCBV map also revealed marked hypoperfusion in these temporal lobe lesions in all patients. The areas of abnormality on the rCBV map were significantly larger than the lesions on the ADC map in 14 patients (observer 1) and 13 patients (observer 2). Since late temporal lobe necrosis is probably caused by damage of the endothelium of vessels and ischemia, perfusion and diffusion mismatch might imply injured tissue but potentially salvageable brain tissue. A mismatch may be potentially used to predict the response to treatment in-patients with late temporal lobe necrosis.
Authors:
E Y Tsui; J H Chan; R G Ramsey; T W Leung; Y K Cheung; S H Luk; K F Lai; K P Wong; D Fong; M K Yuen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of radiology     Volume:  39     ISSN:  0720-048X     ISO Abbreviation:  Eur J Radiol     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-21     Completed Date:  2001-10-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8106411     Medline TA:  Eur J Radiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  133-8     Citation Subset:  IM    
Affiliation:
Department of Diagnostic Radiology, Tuen Mun Hospital, Tuen Mun, NT, Hong Kong. eyktsui@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Contrast Media
Echo-Planar Imaging
Female
Gadolinium DTPA / diagnostic use
Humans
Magnetic Resonance Imaging / methods*
Male
Nasopharyngeal Neoplasms / radiotherapy*
Necrosis
Prospective Studies
Radiation Injuries / diagnosis*
Temporal Lobe / pathology*,  radiation effects
Time Factors
Chemical
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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