Moghrabi A, Tien R, Fuchs H, Longee D, McLendon R, Friedman H S
Department of Pediatrics, Hôpital Ste-Justine, Montreal, Quebec, Canada.
Med Pediatr Oncol. 1997 Feb;28(2):127-31. doi: 10.1002/(sici)1096-911x(199702)28:2<127::aid-mpo6>3.0.co;2-m.
In recent years, major advances in the diagnosis and treatment of patients with brain tumors have been seen. Today, evaluation of the central nervous system almost always includes magnetic resonance imaging (MRI). The appearance of a new lesion on the MRI scan of a patient previously treated for a central nervous system (CNS) tumor raises concern for recurrent disease with the need for selection of new, potentially toxic therapy. However, the sensitivity of MRI may allow demonstration of new lesions which are not due to tumor. We now report three patients with medulloblastoma who demonstrated new enhancing lesions on MRI following treatment of their tumors with surgery (3 patients), chemotherapy (2 patients), and radiotherapy (2 patients). Two patients underwent resection of the lesion revealing gliosis. One patient had serial imaging that showed disappearance of the lesions. This suggests that not all new enhancing lesions in previously treated brain tumor patients represent tumor. Histologic proof of a suspicious lesion should be demonstrated prior to initiation of new therapy.
近年来，脑肿瘤患者的诊断和治疗取得了重大进展。如今，中枢神经系统评估几乎总是包括磁共振成像（MRI）。在先前接受过中枢神经系统（CNS）肿瘤治疗的患者的MRI扫描中出现新病变，引发了对疾病复发的担忧，需要选择新的、可能有毒性的治疗方法。然而，MRI的敏感性可能会显示出并非由肿瘤引起的新病变。我们现在报告三例髓母细胞瘤患者，他们在接受手术（3例）、化疗（2例）和放疗（2例）治疗肿瘤后，MRI上出现了新的强化病变。两名患者对病变进行了切除，显示为胶质增生。一名患者进行了系列成像，显示病变消失。这表明，并非所有先前接受过治疗的脑肿瘤患者中出现的新强化病变都代表肿瘤。在开始新的治疗之前，应证实可疑病变的组织学证据。
