Shen W C, Chen C C, Chiang C M, Liu C K, Lee S K, Lin J C, Jan J S
Department of Radiology, Taichung Veterans General Hospital, Taiwan, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1994 Apr;53(4):208-13.
The normal distribution of red and yellow marrow can be altered by therapeutic irradiation, which causes a well-documented sequence of bone marrow changes. This study measured the T1 signal intensity of the clivus and cervical vertebral bodies of NPC patients who had received a complete course of radiation therapy.
There were 3 categories of patients: Group I: NPC patients who had radiation myelitis; 14 persons which a total 20 times of MRI. Group II: NPC patients, without radiation myelitis; 6 patients, which a total 6 times of MRI. Group III (control group): patients who received MRI of the cervical spine because of cervical spondylosis or HIVD, were total of 45 patients. In the sagittal section of T1WI, the signal intensity of the bone marrow of clivus and C2 to T1 vertebral bodies was measured.
1). There were homogeneous increases of signal intensity of the bone marrow of clivus and C2 to T1 in Groups I and II. 2). There was no statistical difference between Groups I and II. 3). The increased signal intensity of bone marrow after radiation showed no difference in short and long duration between radiation therapy and MR examinations, indicating that bone marrow signal intensities were increased in NPC patients whether or not they had radiation myelitis.
Signal change in bone marrow may have occurred soon after radiation therapy, and may have persisted for several years. The radiation myelitis always involved the low medulla oblongata to C5 level; however, the bone marrow signal change always extended downward to the T1 level, so bone marrow is more sensitive than the spinal cord and is prone to be affected by irradiation.
治疗性放疗可改变红骨髓和黄骨髓的正常分布，这会引发一系列有充分记录的骨髓变化。本研究测量了接受完整疗程放射治疗的鼻咽癌患者斜坡和颈椎椎体的T1信号强度。
患者分为3组：第一组：患有放射性脊髓炎的鼻咽癌患者；14例，共进行20次磁共振成像（MRI）检查。第二组：无放射性脊髓炎的鼻咽癌患者；6例，共进行6次MRI检查。第三组（对照组）：因颈椎病或腰椎间盘突出症接受颈椎MRI检查的患者，共45例。在T1加权成像（T1WI）矢状面上，测量斜坡及C2至T1椎体骨髓的信号强度。
1）. 第一组和第二组斜坡及C2至T1椎体骨髓信号强度均呈均匀增加。2）. 第一组和第二组之间无统计学差异。3）. 放疗后骨髓信号强度增加在放疗与磁共振检查的短期和长期内无差异，表明无论是否患有放射性脊髓炎，鼻咽癌患者骨髓信号强度均会增加。
放疗后骨髓信号变化可能很快发生，并可能持续数年。放射性脊髓炎总是累及延髓下部至C5水平；然而，骨髓信号变化总是向下延伸至T1水平，因此骨髓比脊髓更敏感，更容易受到照射影响。
