MR and cognitive testing of patients undergoing osmotic blood-brain barrier disruption with intraarterial chemotherapy.
OBJECTIVE
To determine whether osmotic blood-brain barrier disruption is associated with MR abnormalities or cognitive deterioration and, if so, whether the MR findings correlate with cognitive test results.


METHODS
Fifteen brain tumor patients who had a complete tumor response (nine central nervous system lymphoma, three germ cell and two astrocytoma, and one primitive neuroectodermal tumor) treated with blood-brain barrier disruption procedures (318 total procedures) with intraarterial chemotherapy were included. MR images were evaluated for the development of white matter hyperintensity, vascular lesions, or atrophy. Cognitive testing was performed to assess deterioration caused by this therapy.


RESULTS
In two patients white matter hyperintensity developed, in two small vascular lesions developed, and in one mild atrophy developed. One infarct was asymptomatic and the second one resulted in mild dysesthesia in one upper extremity. No patient showed diminished cognitive function on the posttherapy evaluation.


CONCLUSIONS
In patients undergoing blood-brain barrier disruption with intraarterial chemotherapy, new abnormalities on MR imaging may develop. These patients maintain the same level of cognitive and neurologic function and MR findings do not correlate with the results of cognitive testing.
Roman-Goldstein
S
S
Department of Diagnostic Radiology, Oregon Health Sciences University, Portland 97201-3098, USA.
Mitchell
P
P
Crossen
J R
JR
Williams
P C
PC
Tindall
A
A
Neuwelt
E A
EA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001812:Blood-Brain Barrier / Q000187:drug effects*; D001921:Brain / Q000187:drug effects / Q000473:pathology; D001925:Brain Damage, Chronic / Q000139:chemically induced / Q000175:diagnosis; D001932:Brain Neoplasms / Q000175:diagnosis / Q000188:drug therapy*; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007261:Infusions, Intra-Arterial; D008279:Magnetic Resonance Imaging; D008297:Male; D008353:Mannitol / Q000008:administration & dosage; D008875:Middle Aged; D009483:Neuropsychological Tests; D016896:Treatment Outcome; D014882:Water-Electrolyte Balance / Q000187:drug effects*
D008353:Mannitol