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目的探究非小细胞肺癌(NSCLC)脑转移全脑放疗(WBRT)后迟发性脑白质病(DLE)的发生率、认知功能变化、MRI影像表现及动态发展过程。方法回顾性分析44例NSCLC脑转移患者WBRT后定期随访MRI及临床资料。结果 NSCLC脑转移WBRT后DLE的MRI表现为弥漫对称性双侧侧脑室旁脑白质长T1、长T2信号,无强化,不累及U型纤维、胼胝体及灰质结构;随访3、6、9、12、18、24、30个月发生率分别为6.82%(3/44)、42.11%(16/38)、68.97%(20/29)、76.19%(16/21)、90%(9/10)、85.71%(6/7)、100%(3/3)。随着DLE的进展,患者的认知功能进一步损伤。结论 WBRT后DLE发生率高,MRI表现为弥漫性脑白质病变,呈进行性发展,且认知功能也随之损伤。
Objective To investigate the incidence of delayed-onset white matter disease (DLE), cognitive function, MRI imaging and dynamic development of non-small cell lung cancer (NSCLC) brain metastases after whole brain irradiation (WBRT). Methods We retrospectively analyzed the MRI and clinical data of 44 patients with NSCLC brain metastasis after WBRT. Results The MRI findings of DLE in NSCLC after brain metastases from WBRT were diffuse symmetry bilateral long-term T1 and long T2 signs of left ventricular periventricular white matter. There was no enhancement and no involvement of U-fiber, corpus callosum and gray matter structure. Follow-up 3, 6, 9, , Respectively. The incidence rates at 18, 24 and 30 months were 6.82% (3/44), 42.11% (16/38), 68.97% (20/29), 76.19% (16/21), 90% ), 85.71% (6/7), 100% (3/3). As DLE progresses, the patient’s cognitive function is further impaired. Conclusions After WBRT, the incidence of DLE is high, and MRI manifests as diffuse leukoencephalopathy. It progresses progressively and the cognitive function is also impaired.