Department of Physics and Astronomy University of British Columbia Vancouver British Columbia Canada.
Department of Pediatrics University of British Columbia Vancouver British Columbia Canada.
Ann Clin Transl Neurol. 2018 Dec 10;6(2):379-385. doi: 10.1002/acn3.704. eCollection 2019 Feb.
Radiation necrosis mostly occurs in and near the radiation field. We used magnetic resonance imaging to study radiation-induced necrosis of atypical onset, severity, and extent following stereotactic radiosurgery for a symptomatic arteriovenous malformation. Susceptibility-sensitive imaging, T-relaxation, myelin water imaging, and magnetic resonance spectroscopy were acquired three times up to 52 months postradiosurgery. Increasing water content outside the radiation field, contralateral neuronal loss, and gliosis were detected over time. Our findings suggest that radiation-induced vasculopathic changes spread more diffusely than previously described. An autoimmune response to brain antigens could underlie white matter changes outside the initial radiation field.
放射性坏死主要发生在放射野内及附近。我们使用磁共振成像来研究立体定向放射外科治疗症状性动静脉畸形后非典型发病、严重程度和范围的放射性坏死。在放射外科治疗后长达 52 个月的时间内，我们进行了 3 次敏感性成像、T1 弛豫、髓鞘水成像和磁共振波谱检查。随着时间的推移，在外照射野之外检测到含水量增加、对侧神经元丢失和神经胶质增生。我们的发现表明，放射诱导的血管病变变化比以前描述的更为弥散。针对脑抗原的自身免疫反应可能是初始放射野外的白质变化的基础。
