Capps G W, Fulcher A S, Szucs R A, Turner M A
Department of Radiology, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0615, USA.
Radiographics. 1997 Nov-Dec;17(6):1455-73. doi: 10.1148/radiographics.17.6.9397458.
After external-beam radiation therapy, radiation-induced changes may be observed in abdominal and pelvic organs at imaging. In the liver, an area of low attenuation corresponding to the radiation port (or an area of hyperattenuation if the underlying liver tissue shows fatty change) can be seen at computed tomography (CT) performed within 3-6 months after therapy. Later, the liver may be fibrotic and contracted. In the stomach, small intestine, and colon, wall thickening and edema are early manifestations. Ulcers may also be observed. Long-term complications include strictures and fistulas. After irradiation of the kidneys, altered attenuation of the renal parenchyma may be seen at CT. Ureteral strictures, typically involving the distal ureter, may be observed after pelvic irradiation. The bladder may be small and contracted with a thickened wall after radiation exposure. Fistulas between the bladder and other pelvic organs sometimes occur. Typical musculoskeletal changes include growth abnormalities in skeletally immature patients, fatty replacement of bone marrow, and radiation osteitis. Radiation-induced neoplasms are also recognized after therapy.
外照射放射治疗后，在影像学检查中可观察到腹部和盆腔器官出现辐射诱导的变化。在肝脏，治疗后3至6个月内进行的计算机断层扫描（CT）可显示与放射野相对应的低密度区域（如果肝脏组织存在脂肪变性，则为高密度区域）。之后，肝脏可能会发生纤维化和萎缩。在胃、小肠和结肠，壁增厚和水肿是早期表现。也可能观察到溃疡。长期并发症包括狭窄和瘘管。肾脏照射后，CT可显示肾实质密度改变。盆腔照射后可能观察到输尿管狭窄，通常累及输尿管远端。辐射暴露后，膀胱可能会变小、萎缩且壁增厚。膀胱与其他盆腔器官之间有时会出现瘘管。典型的肌肉骨骼变化包括骨骼未成熟患者的生长异常、骨髓脂肪替代和放射性骨炎。治疗后也会出现辐射诱导的肿瘤。
