Borruat F X, Schatz N J, Glaser J S
Hôpital Ophtalmique Jules Gonin, Lausanne.
Klin Monbl Augenheilkd. 1996 May;208(5):381-4. doi: 10.1055/s-2008-1035247.
Radiation optic neuropathy (RON) is a rare, unpredictable, late complication of radiotherapy secondary to obliterative endarteritis. Tumor recurrence has to be ruled out by a clinical and neuroradiological examination.
Five patients with RON were investigated by magnetic resonance imaging (MRI) during 1992.
Radiation-induced lesions of the intracranial visual pathways were easily visible on MRI. Without Gadolinium, a sectorial swelling was detectable, which markedly enhanced with Gadolinium. Intracranial optic nerve was affected in 5/5 cases, optic chiasm in 3/5 cases, and optic tract in 2/5 cases.
MRI is the examination of choice when RON is suspected: it will easily delineate the extent of the lesion, and compression/infiltration by a recurrent tumor will be formally ruled out. A segmental swelling of visual pathway with marked Gadolinium enhancement on MRI is highly suggestive of radionecrosis.
放射性视神经病变（RON）是放疗继发闭塞性动脉内膜炎后一种罕见、不可预测的晚期并发症。必须通过临床和神经放射学检查排除肿瘤复发。
1992年期间，对5例RON患者进行了磁共振成像（MRI）检查。
MRI上很容易看到颅内视觉通路的放射性损伤。在未使用钆剂时，可检测到扇形肿胀，使用钆剂后明显强化。5例患者中颅内视神经均受累，3例累及视交叉，2例累及视束。
怀疑RON时，MRI是首选检查方法：它能轻松描绘病变范围，并可明确排除复发肿瘤的压迫/浸润。MRI上视觉通路节段性肿胀并伴有明显钆剂强化高度提示放射性坏死。
