Fig. 9
From: Brain MR findings in patients treated with particle therapy for skull base tumors
MRI performed 10 months after 74 Gy proton-beam therapy in the same patient of Fig. 3, who previously underwent subtotal surgical resection of clival chordoma. Axial T2-weighted image (a) shows hyperintensy involving subcortical white matter and gray matter in left polar and mesial temporal regions right adjacent to clival structures. Axial post-contrast T1-weighted image (b) reveals the presence of a round-shaped contrast-enhancing lesion within the hyperintense area. Multi-voxel MRS (c) shows a choline (Cho) peak and an increase/inversion of choline/N-acetylaspartate (Cho/NAA) ratio, which may reflect inflammatory cells infiltrate in early brain damage