Department of Neuroradiology, The West Wing, John Radcliffe Hospital, Oxford Radcliffe NHS Trust, Oxford, UK.
Clin Radiol. 2012 Jan;67(1):61-8. doi: 10.1016/j.crad.2011.01.010. Epub 2011 Nov 3.
Corporeal and central nervous system (CNS) axis chemotherapy and radiotherapy have long been used for the effective treatment and prophylaxis of CNS, body malignancies, and leukaemias. However, they are not without their problems. Following the proliferation of magnetic resonance neuroimaging in recent years it has become clear that the spectrum of toxicity that these therapies produce ranges from subclinical white matter changes to overt brain necrosis. The effects are both direct and indirect and via different pathological mechanisms. Chronic and progressive changes can be detected many years after the initial intervention. In addition to leucoencephalopathic changes, grey matter changes are now well described. Changes may be difficult to distinguish from tumour recurrence, though may be reversible and remediable, and are thus very important to differentiate. In this review toxic effects are classified and their imaging appearances discussed, with reference to specific syndromes.
体部和中枢神经系统（CNS）轴化疗和放疗长期以来一直被用于有效治疗和预防 CNS、身体恶性肿瘤和白血病。然而，它们并非没有问题。近年来，随着磁共振神经影像学的普及，人们已经清楚地认识到，这些治疗方法所产生的毒性谱从亚临床的白质变化到明显的脑坏死不等。这些影响既有直接的，也有间接的，通过不同的病理机制。在最初的干预措施之后很多年，都可以检测到慢性和进行性的变化。除了脑白质病变化，现在也很好地描述了灰质变化。这些变化可能难以与肿瘤复发相区分，尽管可能是可逆和可补救的，因此非常重要的是要进行区分。在这篇综述中，我们对毒性作用进行了分类，并讨论了它们的影像学表现，同时参考了特定的综合征。
