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放射性脑坏死的机制目前还不完全清楚,主要学说有血管假说和胶质细胞假说两种,但可能有多种机制共同参与。放射性坏死与肿瘤复发的鉴别有了很大进展,可通过MRI平扫、MRI加权成像、MRI灌注成像、磁共振波谱(MRS)、单光子发射计算机断层扫描(SPECT)和正电子发射断层扫描(PET)等方法或几种方法联合加以鉴别。二者的处理也完全不同,肿瘤复发多需更换化疗药物或手术治疗,而放射性坏死多可应用药物如激素等保守治疗。本文对放射性坏死的机制、鉴别诊断以及治疗方法的最新进展进行概述。
The mechanism of radioactive brain necrosis is not yet fully understood. The main theories include vascular hypothesis and glial cell hypothyroidism, but there may be multiple mechanisms involved. Radiological necrosis and the identification of tumor recurrences have progressed through MRI, MRI-weighted imaging, MRI perfusion imaging, MRS, SPECT, and PET ) And other methods or combination of several methods to be identified. The two are also completely different treatment, tumor recurrence need to be replaced more chemotherapy drugs or surgical treatment, and more use of radioactive necrosis of drugs such as hormones and other conservative treatment. This article provides an overview of the mechanism of radiation necrosis, differential diagnosis and treatment of the latest progress.