PMC9911823_01
(A) The axial T2-weighted FLAIR imaging demonstrated irregular hypointense signal changes with patchy edema around them in the bilateral temporal lobes (arrows) and (B) without contrast enhancement in the similar brain structures. The MRI abnormalities on bilateral temporal lobes had been present for approximately 5 months before the patient's disturbance of consciousness. These abnormalities were presentation of radiation-induced brain necrosis and were not associated with E. miricola encephalitis. (C) Nasopharynx T2-weighted FLAIR imaging showed a heterogeneous signal mass in the left nasopharyngeal lateral wall (arrow). (D) T1-weighted nasopharynx MRI with contrast enhancement showed enhancing lesions in the mass (arrow). FLAIR, fluid-attenuated inversion-recovery.
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F1
Magnetic resonance imaging (MRI) of the brain revealed irregular hypointense signal changes with patchy edema around them in the bilateral temporal lobes (Figure 1A), without enhancing lesions in the same brain structures (Figure 1B). Nasopharynx MRI showed a heterogeneous signal mass in the left nasopharyngeal lateral wall (Figure 1C) and enhancement in the mass (Figure 1D). 18F-Fluoro-2-deoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scan demonstrated decreased fluorodeoxyglucose uptake lesions in the bilateral temporal lobes (Figures 2A-C) and increased fluorodeoxyglucose uptake lesions in the left nasopharyngeal lateral wall (Figures 2D-F).
(A) PET scan revealed decreased fluorodeoxyglucose uptake in the bilateral temporal lobes (arrows). (B) CT scan showed patchy low-density areas in the bilateral temporal lobes (arrows). (C)
18F-FDG PET/CT fusion imaging demonstrated decreased fluorodeoxyglucose uptake in the bilateral temporal lobes (arrows). These metabolic abnormalities on bilateral temporal lobes were appearance of radiation-induced brain necrosis and were not correlated with E. miricola encephalitis. (D) PET scan revealed increased fluorodeoxyglucose uptake in the left nasopharyngeal lateral wall (arrow). (E) CT scan showed soft tissue mass with unclear boundary in the left nasopharyngeal lateral wall (arrow). (F)
18F-FDG PET/CT fusion imaging demonstrated increased fluorodeoxyglucose uptake in the left nasopharyngeal lateral wall (arrow). 18F-FDG PET/CT, and 18F-Fluoro-2-deoxyglucose positron emission tomography/computed tomography.
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F2
Nasopharynx MRI showed a heterogeneous signal mass in the left nasopharyngeal lateral wall (Figure 1C) and enhancement in the mass (Figure 1D). 18F-Fluoro-2-deoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) scan demonstrated decreased fluorodeoxyglucose uptake lesions in the bilateral temporal lobes (Figures 2A-C) and increased fluorodeoxyglucose uptake lesions in the left nasopharyngeal lateral wall (Figures 2D-F).