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Late radiation injury to the temporal lobes: morphologic evaluation at MR imaging
Y L Chan1, S F Leung, A D King
1Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, People's Republic of China. yl190chan@cuhk.edu.hk
Purpose:
To study the morphologic characteristics of late radiation injury to the temporal lobes of the brain on magnetic resonance (MR) images.
Materials And Methods:
This was a prospective study involving 34 patients (age range, 37-72 years) with known radiation injury to the temporal lobes from radiation therapy administered 2-10 years previously for nasopharyngeal carcinoma MR imaging was performed with T2-weighted gradient- and spin-echo, gradient-recalled echo, T1-weighted spin-echo, fluid-attenuated inversion-recovery, and T1-weighted postcontrast spin-echo sequences.
Results:
Radiation injury was present in 57 of the 68 temporal lobes. The white matter lesions in radiation-induced injury were predominantly hyperintense on T2-weighted images, but in 37 (65%) of the 57 lobes, foci with heterogeneous signal intensity consistent with necrosis were detected. In the 57 involved lobes, gray matter lesions were detected in 50 (88%); blood-brain barrier disruption based on parenchymal contrast enhancement, in 51 (89%); and hemosiderin deposits, in 30 (53%). There was a significant correlation between white matter necrosis, gray matter lesions, and blood-brain barrier disruption, all of which were located mainly in the inferior temporal lobes that received the highest radiation dose.
Conclusion:
The lesion components of radiation-induced injury to the temporal lobes at MR imaging were more varied than have been previously described. In addition to the classic white matter lesions, gray matter lesions, blood-brain barrier disruption, and hemosiderin deposition also were frequently seen.