Magnetic resonance imaging of cranial radiation lesions

Fifty-six patients who previously received therapeutic cranial irradiation (CRT) were imaged by a 1.5 Magnetic Resonance (MR) System 0.1-11 years following CRT. Abnormal MR findings within the treatment volume unrelated to tumor, prior to surgery, or coexisting conditions were reviewed for an association with CRT. Twenty-four patients had MR abnormalities considered to be attributable to CRT. These were scored as mild (Grade I) in 6, moderate (Grade II) in 9, and severe (Grade III) in 9. Eight of these 24 patients with CRT findings on MR had CT abnormalities that correlated with the MR. Six lesions seen on computed tomography (CT) were Grade III abnormalities; all were judged as being visualized better by MR. Eight patients had significant neurologic dysfunction attributable to their CRT lesions, and 7 of these had Grade III lesions. Whereas the clinical significance of mild or moderate CRT effects seen on MR is uncertain, Grade III (severe) MR lesions correlate well with important clinical findings.