MRI features of chemotherapy complicating by posterior reversible encephalopathy syndrome

doi:10.3877/cma.j.issn.2095-655X.2021.04.011

Abstract

Abstract:

Objective

To explore MRI features of chemotherapy complicating by posterior reversible encephalopathy syndrome (PRES) in patients with malignant tumors.

Methods

From February 2012 to December 2020, clinical and MRI data of 7 patients with malignant tumors complicated by PRES after chemotherapy who were treated in Oncology Department of Changzhou Cancer Hospital of Soochow University were retrospectively analyzed.All patients had head MRI data before chemotherapy, and no brain metastasis was confirmed. MRI imaging of 7 patients included T₂WI, T₁WI, FLAIR and DWI sequences, 3 of the patients underwent contrast enhancement.

Results

MRI showed bilaterally symmetrical distributions of lesions. Bilateral occipital lobe and parietal lobe were involved in 7 patients, bilateral frontal lobe in 3 cases and bilateral cerebellar hemisphere in 2 cases. The lesions appeared as hypointense on T₁WI, hyperintense on T₂WI and FLAIR, slightly hyperintense on DWI. In 3 patients with enhanced scanning, 1 case was not enhanced obviously, 2 cases appeared linear or nodular enhancement, including large patch enhancement in 1 case after a week. The lesions were reduced or disappeared after one to two weeks with treatment in all cases, and lacunar infarction of new area was found in 2 patients.

Conclusion

Clinical data combined with MRI is of great significance for the correct diagnosis of chemotherapy complicating by PRES in patients with malignant tumors.

Key words: Chemotherapy, Magnetic resonance imaging, Posterior reversible encephalopathy syndrome

Xinhua Xu, Jin Zhang. MRI features of chemotherapy complicating by posterior reversible encephalopathy syndrome[J]. Chinese Journal of Diagnostics(Electronic Edition), 2021, 09(04): 264-267.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhzdxdzzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-655X.2021.04.011

https://zhzdxdzzz.cma-cmc.com.cn/EN/Y2021/V09/I04/264

Figures/Tables 2

References 17

[1]	潘仲林，朱友志，贺明庆，等．后部可逆性脑病综合征影像学表现(附1例报告及文献复习) [J]．实用放射学杂志，2009，25(7)：943-946.
[2]	Liman TG, Bohner G, Heuschmann PU, et al. The clinical and radiological spectrum of posterior reversible encephalopathy syndrome：the retrospective Berlin PRES study[J]．J Neurol，2012，259(1)：155-164.
[3]	Hinchey J, Chaves C, Appignani B, et al. A reversible posterior leukoencephalopathy syndrome[J]．N Engl J Med，1996，334(8)：494-500.
[4]	汤群锋，吴力源，陈宏伟，等．脑后部可逆性脑病综合征与MELAS的磁共振特征对照研究[J]．磁共振成像，2012，3(1)：24-29.
[5]	Fugate JE, Rabinstein AA.Posterior reversible encephalopathy syndrome：clinical and radiological manifestations，pathophysiology，and outstanding questions[J]．Lancet Neurol，2015，14(9)：914-925.
[6]	Zekić T, Benić MS, Antulov R，et al.The multifactorial origin of posterior reversible encephalopathy syndrome in cyclophosphamide-treated lupus patients[J]．Rheumatol Int，2017，37(12)：2105-2114.
[7]	Parikh NS, Schweitzer AD, Young RJ，et al. Corticosteroid therapy and severity of vasogenic edema in posterior reversible encephalopathy syndrome[J]．J Neurol Sci，2017(380)：11-15.
[8]	Bansal S, Bansal R, Goyal MK, et al. Clinical, etiological and imaging profile of posterior reversible encephalopathy syndrome：a prospective and follow-up study[J]．Ann Indian Acad Neurol，2020，23(2)：182-188.
[9]	郭慧，张云亭．后循环可复性脑病综合征临床及影像表现[J]．国际医学放射学杂志，2015，38(3)：216-219，252.
[10]	Li J, Zhao XM, Chen L，et al.Safety and pharmacokinetics of novel selective vascular endothelial growth factor receptor-2 inhibitor YN968D1 in patients with advanced malignancies[J]. BMC Cancer，2010(10)：529.
[11]	秦叔逵，李进．阿帕替尼治疗胃癌的临床应用专家共识[J]．临床肿瘤学杂志，2015，20(9)：841-847.
[12]	Xie CQ, Jones VT.Reversible posterior leukoencephalopathy syndrome following combinatorial cisplatin and pemetrexed therapy for lung cancer in a normotensive patient：a case report and literature review[J]．Oncol Lett，2016，11(2)：1512-1516.
[13]	Katada E, Mitsui A, Sasaki S，et al.Posterior reversible encephalopathy syndrome after a variety of combined chemotherapies containing bevacizumab for metastatic colon cancer[J]. Intern Med，2018，57(16)：2403-2407.
[14]	梁德壬．可逆性后部脑病综合征的影像学表现[J]．实用放射学杂志，2011，27(12)：1801-1803，1815.
[15]	Ninomiya I, Kanazawa M, Akaiwa Y，et al.Apparent diffusion coefficient reduction might be a predictor of poor outcome in patients with posterior reversible encephalopathy syndrome[J]．J Neurol Sci，2017(381)：1-3.
[16]	Bartynski WS.Posterior reversible encephalopathy syndrome，part 2：controversies surrounding pathophysiology of vasogenic edema[J]．AJNR Am J Neuroradiol，2008，29(6)：1043-1049.
[17]	叶红，李军杰，武力勇．重视新型抗肿瘤药物相关可逆性后部脑病综合征[J]．药物不良反应杂志，2021，23(5)：225-227.

Please choose a citation manager

Content to export