Immediate post op MRI post contrast: Hygino et al 2011
- Increased enhancement can be induced by a variety of nontumoral processes, such as treatment-related inflammation, postsurgical changes, ischemia, subacute radiation effects, and radiation necrosis.
- Micro-ischemic lesions immediately after surgery and RT can cause BBB disruption.
- Therefore, contrast-enhanced MR imaging should be used within the first 48 hours after surgery to identify residual tumour in the postsurgical bed, and no later than 72 hours after surgery to avoid confusion with nontumoral inflammation
- Regions with restricted diffusion on an immediately postoperative MR imaging will commonly enhance subacutely for up to 2–3 months after surgery; these are typically thought of as postoperative ischemic changes.
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