鼻咽癌放疗后脑神经损伤的MRI表现

MRI imaging of cranial nerve involvement after radiotherapy for nasopharyngeal carcinoma

目的探讨鼻咽癌放疗后脑神经损伤的原因及其MRI表现。方法选择临床和MRI资料完整的36例患者进行回顾性分析,采用1.5T MR行头颅、鼻咽部横轴位、冠状位和矢状位平扫以及增强扫描成像,对MRI图像进行分析。结果①脑神经第Ⅵ、Ⅴ、X、Ⅻ对损害占前四位;②鼻咽癌局部复发引起脑神经损伤17例,单纯放射性神经损害12例,复发与放射性脑病并存的7例。结论鼻咽癌放疗后脑神经损伤有肿瘤复发、放射性脑病和两者共存三方面原因。MRI检查能早期、准确显示脑神经损伤。

Objective To explore cranial nerve involvement after radiotherapy for nasopharyngeal carcinoma. Methods 36 cases with whole clinical data and MRI data were selected. We applied 1.5 T MRI scaner and T1WI,T2WI,FS TzWI, GD-DTPA contrast medium enhancement scan to every patients with axial, coronal and sagittal tomography and contrast enhancement of head and nasopharynx. Results The damage of , V , X, XII cranial nerves was the most common; cases had local recurrence of nasopharyngeal carcinoma （NPC） and injure cranial nerve. 12 cases only had radioactive nerve damage. 7 cases had both. Conclusion There are three reasons of Cranial nerve involvement after radiotherapy for nasopharyngeal carcinoma： recurrence of nasopharyngeal carcinoma and invasion of the cranial nerve, radioactive nerve damage, and or both. MRI can early and accurately diagnose the cranial nerve involvement.