Mineura K, Sasajima T, Kowada M, Shishido F, Uemura K
Neurosurgical Service, Akita University Hospital, Japan.
Pediatr Neurosurg. 1991;17(4):200-2. doi: 10.1159/000120597.
A 2-year-old girl with medulloblastoma who had postoperative radiotherapy and intrathecal administration of methotrexate is reported. Five months after radiation and chemotherapy, she developed involuntary movement. Positron emission tomography (PET) demonstrated that the metabolic rate of glucose was depressed markedly in the temporal and occipital lobes, indicative of metabolic depression induced by radiation. Prompt initiation of steroid therapy ameliorated the patient's neurological symptoms. Follow-up PET revealed an increase in 18F-fluorodeoxyglucose uptake in the entire brain, including temporal and occipital lesions. No areas with high accumulation of (11C-methyl)-L-methionine were detectable. We concluded that PET may be useful in establishing an early diagnosis of radiation injury of the brain and in monitoring metabolic changes following radiation in brain tumor patients.
报告了一名患有髓母细胞瘤的2岁女孩，她接受了术后放疗和鞘内注射甲氨蝶呤。放疗和化疗5个月后，她出现了不自主运动。正电子发射断层扫描（PET）显示颞叶和枕叶葡萄糖代谢率明显降低，提示辐射诱导的代谢抑制。及时开始使用类固醇治疗改善了患者的神经症状。随访PET显示，包括颞叶和枕叶病变在内的全脑18F-氟脱氧葡萄糖摄取增加。未检测到（11C-甲基）-L-蛋氨酸高度聚集的区域。我们得出结论，PET可能有助于早期诊断脑辐射损伤，并监测脑肿瘤患者放疗后的代谢变化。
