对胶质瘤术后复发及放射性脑损伤鉴别诊断的影像学研究进展

Advances of imaging on differential diagnosis between recurrence of glioma and radiation-induced brain injury

胶质瘤术后复发及放射治疗所致放射性脑损伤的鉴别诊断是临床面临的一大挑战,两者在临床表现及传统影像学上具有相似的特点,但在组织病理学及治疗措施上却显著不同,因此,运用影像学手段对两者进行鉴别具有重要的临床意义。就扩散加权成像、磁共振波谱、动态对比增强成像、动态磁敏感对比增强成像、正电子发射计算机体层摄影术、单光子发射计算机体层摄影术在鉴别胶质瘤复发和放射性脑损伤中应用的国内外最新研究结果予以综述,以期对临床诊疗提供帮助。

Differentiating recurrence of glioma from radiation-induced brain injury is a central challenge in neurooncology. The 2 very different outcomes after brain tumor treatment often appear similar on traditional imaging studies. They may even manifest with similar clinical symptoms. Distinguishing treatment injury from tumor recurrence is crucial for diagnosis and treatment planning. In this article, we reviewed the latest developments and key findings from research studies exploring the efficacy of structural and functional imaging modalities in differentiating treatment injury from tumor recurrence with DWI, MRS, DCE-MR, DSC-MR, PET, and SPECT. And we discussed the advantages and disadvantages of each approach to provide useful information for making proper diagnosis and treatment planning.