Department of Diagnostic Imaging, Institute of Mother and Child, Warszawa, Poland.
Adv Clin Exp Med. 2016 Jul-Aug;25(4):789-97. doi: 10.17219/acem/37716.
The amount of people living with cancer is increasing; they live longer and have thus a higher risk of developing neurological complications. Magnetic resonance as a diagnostic procedure of choice in detecting the reasons of neurological/psychiatric symptoms in oncological patients is nowadays relatively easily accessible. Early diagnosis established by radiologists familiar with neurological entities that may follow cancer treatment allow clinicians to provide proper treatment, even if the diagnosis seems unbelievable. The review of MR images of acute and chronic neurological complications of cancer treatment from the authors' own archive is the focus of this report. Neurological complications of cancer can be metastatic and non-metastatic; the first cannot be considered as a treatment complication, the latter can be chemoor radiotherapy-induced, acute, chronic and delayed. In our material we dealt with complications with dramatic course (stroke, PRES, acute leukoencephalopathy, Wernicke's encephalopathy) and with cases with milder and/or longer course (neuro-infections, chronic leukoencephalopathy, telangiectasias and/or cavernous hemangiomas, second tumors: glioma and meningioma after irradiation). The central nervous system is very susceptible to complications of systemic cancer and its treatment. Even though the first thought of clinicians and radiologists after a patient's first neurological/psychiatric symptoms appears concerns the metastatic spread of the disease, they need to have an understanding that there are a number of other causes of such symptoms. The knowledge of entities which can be expected and diagnostic experience prevent clinicians from making wrong diagnosis.
癌症患者的人数正在增加；他们的寿命更长，因此患神经并发症的风险更高。磁共振成像作为一种诊断程序，用于检测肿瘤患者神经/精神症状的原因，在当今相对容易获得。放射科医生通过早期诊断熟悉可能随癌症治疗而出现的神经学实体，从而为临床医生提供适当的治疗，即使这种诊断似乎难以置信。本文回顾了作者自己档案中癌症治疗急性和慢性神经并发症的磁共振图像。癌症的神经并发症可以是转移性的，也可以是非转移性的；前者不能被认为是治疗并发症，后者可以是化疗或放疗引起的，急性、慢性和延迟性的。在我们的材料中，我们处理了病程急剧的并发症（中风、 PRES、急性脑白质病、Wernicke 脑病）和病程较轻和/或较长的并发症（神经感染、慢性脑白质病、毛细血管扩张症和/或海绵状血管瘤、第二肿瘤：放疗后胶质瘤和脑膜瘤）。中枢神经系统非常容易受到全身癌症及其治疗的并发症的影响。尽管临床医生和放射科医生在患者出现首次神经/精神症状后首先想到的是疾病的转移扩散，但他们需要了解还有许多其他原因会导致这些症状。对可能出现的实体的了解和诊断经验可以防止临床医生做出错误的诊断。
