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FIG 1. Images obtained in a 54-year-old man with biopsy-proven radiation necrosis after receiving radiation and chemotherapy for anaplastic oligodendroglioma.
A, Gadolinium-enhanced T1WI image shows an irregular ring-enhancing lesion with mass effect.
B, DWI image obtained at the same level as A shows a mixed SI pattern (arrowheads), with marked hypointensity (arrow), which is typical for radiation necrosis. Radiation necrosis may have a variety of SI patterns on DWI images, reflecting the development of necrosis. Marked DWI hypointensity is probably attributable to liquefactions in late-stage necrosis.
C, ADC map, which corresponds to B, shows a mixed SI pattern, with a markedly high ADC value (arrow).
D and E, Histopathological specimens (hematoxylin-eosin, x20 [D], x40 [E]) show total parenchymal necrosis with hemorrhage. No evidence of viable tumor cells was found.
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