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脳腫瘍術後,放射線治療後の症例では,再発と放射線壊死の鑑別は治療方針の決定において重要であるが,ガドリニウム造影MRIを含めた形態学的評価のみでは診断に苦慮することも多い。MRIによる両者の鑑別,診断能を高めるためにdiffusion weighted imaging(DWI),dynamic susceptibility contrast(DSC)法などを用いたperfusion imaging,MR spectroscopy(MRS)などの先進撮影法による検討がされてきた。本稿では,これらの先進撮影法による両者の鑑別などについて,最新の知見も含めてまとめた。
It is important to detect tumor recurrence early for patients with glioma for optimal treatment modification. However, differentiating recurrent tumors from radiation necrosis by conventional MRI remains challenging because of the overlaps of the findings. Advanced MRI techniques have been investigated to improve diagnostic performance for recurrence tumors. In this review, we describe the usefulness of advanced MRI techniques, including DWI, perfusion imaging, and 1H-MRS, to differentiate recurrent tumors from radiation necrosis.
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