title: MRI assessment of local acute radiation syndrome.
abstract: OBJECTIVE
  To describe local acute radiation syndrome and its radiological imaging characteristics.
  
  
  METHODS
  We performed a retrospective study of patients who had suffered skin and deeper radiation damage who were investigated by magnetic resonance imaging (MRI). We compared the clinical findings, C-reactive protein (CRP) levels and MRI results.
  
  
  RESULTS
  A total of 22 MRI examinations were performed between 2005 and 2010 in 7 patients; 6 patients had increased CRP levels and MRI abnormalities. They were treated by surgery and local cellular therapy. One patient had no CRP or MRI abnormalities, and had a spontaneous good outcome. Eighteen abnormal MR examinations demonstrated high STIR signal and/or abnormal enhancement in the dermis and muscle tissues. Three MRI examinations demonstrated skeletal abnormalities, consistent with radionecrosis. The four normal MRI examinations were associated only with minor clinical manifestations such as pain and pigmentation disorders.
  
  
  CONCLUSIONS
  MRI seems to be a useful and promising imaging investigation in radiation burns management i.e. initial lesion evaluation, treatment evaluation and complication diagnosis. MRI findings correlated perfectly with clinical stage and no false negative examinations were obtained. In particular, the association between normal MRI and low CRP level seems to be related to good outcome without specific treatment.
  
  
  CONCLUSIONS
  Local acute radiation syndrome (radioepidermitis) mainly affects the skin and superficial tissues. MRI findings correspond with clinical stage (with a strong negative predictive value). MRI outperformed X-ray examination for the diagnosis of bone radionecrosis. Diffusion-weighted imaging shows low ADC in bone and soft tissue necrosis. Perfusion sequence allows assessment of tissue microcirculation impairment.
authors: Radiology Department, Military Hospital Percy, 101 avenue Henri Barbusse, 92140, Clamart, France. weberdonatgabrielle@yahoo.fr
authors: G
authors: G
authors: Weber-Donat
authors: J-C
authors: JC
authors: Amabile
authors: M
authors: M
authors: Lahutte-Auboin
authors: J
authors: J
authors: Potet
authors: J
authors: J
authors: Baccialone
authors: E
authors: E
authors: Bey
authors: C
authors: C
authors: Teriitehau
authors: P
authors: P
authors: Laroche
mesh_terms: D054508:Acute Radiation Syndrome / Q000175:diagnosis* / Q000628:therapy; D000328:Adult; D002097:C-Reactive Protein / Q000032:analysis; D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D002097:C-Reactive Protein; D019786:Gadolinium DTPA