title: Postoperative changes in the brain: MR imaging findings in patients without neoplasms.
abstract: OBJECTIVE
  To determine the time course of postoperative changes in the brain by using magnetic resonance (MR) imaging.
  
  
  METHODS
  Contrast material-enhanced MR images (32 preoperative, 161 postoperative) in 95 patients who underwent temporal lobectomy for treatment of nonneoplastic epilepsy were evaluated for enhancement pattern at the surgical margin and for the presence of dural enhancement, fluid, and air. Images were obtained 9 hours to 5.6 years after surgery.
  
  
  RESULTS
  Surgical margin contrast enhancement was present and increased from 20 hours to 29 days after surgery. The predominant early (days 0-5) pattern was thin linear enhancement (16 of 18 [89%] images). The later (days 6-29) pattern was thick linear or nodular (tumorlike appearance) (11 of 18 [61%] images). Surgical margin enhancement was absent after day 30, although few data were collected 1-5 months after surgery. Dural enhancement was seen on 96 of 97 (99%) postoperative MR images. Extraaxial fluid was seen on all 46 images obtained during the first 30 days and was absent by day 51. Intracranial air was present on 31 of 35 (89%) images obtained during the first 4 days but was absent after day 5.
  
  
  CONCLUSIONS
  Knowledge of the evolution of contrast enhancement patterns on postoperative MR images of the brain can help in differentiating benign from neoplastic changes.
authors.affiliation: Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT 06520-8042, USA.
authors.forename: N
authors.initials: N
authors.lastname: Sato
authors.forename: R A
authors.initials: RA
authors.lastname: Bronen
authors.forename: G
authors.initials: G
authors.lastname: Sze
authors.forename: Y
authors.initials: Y
authors.lastname: Kawamura
authors.forename: W
authors.initials: W
authors.lastname: Coughlin
authors.forename: C M
authors.initials: CM
authors.lastname: Putman
authors.forename: D D
authors.initials: DD
authors.lastname: Spencer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology*; D002648:Child; D004388:Dura Mater / Q000473:pathology; D004833:Epilepsy, Temporal Lobe / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013702:Temporal Lobe / Q000601:surgery*; D013997:Time Factors