Summary:
The authors demonstrate the observations of four patients with radiation myelopathy, localized in
three instances in the cervical spinal cord - the basic disease was pleomorphic adenocarcinoma of
the parotid gland, malignant immunoblastic lymphoma of the hard palate and pavement carcinoma
of the tonsil. In the latter patient after irradiation of metastases of the pulmonary carcinoma in the
mediastinum the thoracic spinal cord was affected. The onset of clinical symptoms occurred in these
four cases between the 6th and 11th months after termination of actinotherapy, all MRexaminations
were made 1 - 3 months later. In all patients nonomogeneous foci were detected at the level
corresponding to the irradiated tumourous process and three times the spinal cord was markedly
expanded by oedema. The authors draw attention to the importance of detection of postirradiation
changes in the surroundings of the spinal cord (diffuse fatty degeneration of the bone marrow of
vertebral bodies) for assessment of the etiology of the affection.
Key words:
MR imaging - radiotherapy, complications - myelopathy, differential diagnosis
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