Asymptomatic radiation-induced telangiectasia in children after cranial irradiation: frequency, latency, and dose relation

Radiology. 2004 Jan;230(1):93-9. doi: 10.1148/radiol.2301021143. Epub 2003 Nov 26.


Purpose: To determine the frequency, dose relation, and latency of radiation-induced telangiectasias in children after cranial irradiation.

Materials and methods: The authors identified 90 children who had undergone cranial irradiation between 1981 and 2001 and undergone magnetic resonance (MR) imaging with follow-up for at least 6 months. Patients were assigned to low-dose (LD) and high-dose (HD) groups. All 24 children in the LD group received a radiation dose of 18.0 or 19.8 Gy. The 66 patients in the HD group received a dose of 32.0 Gy or greater. Telangiectasias were defined as small low-signal-intensity foci on intermediate- or T2-weighted MR images. For the patients who underwent serial MR imaging, the first depicted appearance of each telangiectatic lesion was recorded. Statistical analyses were performed.

Results: Telangiectasias in at least one area were observed in 18 (20%) patients. The frequency of telangiectasia was 13% (three of 24 patients) in the LD group as compared with 23% (15 of 66 patients) in the HD group; this difference was not significant (P =.22, Fisher exact test). In 12 patients (one from LD and 11 from HD group) who underwent serial MR imaging follow-up for up to 10 years (mean, 8.1 years), a total of 31 lesions were detected. Twelve (39%) of these lesions were detected by the 3rd year, and 21 (68%) were evident by the 5th year. Six (50%) of the 12 patients who underwent serial MR imaging had telangiectatic foci after 5 years.

Conclusion: Radiation-induced telangiectasia appears to occur in at least 20% of children who undergo cranial irradiation. In this small series, higher radiation dose was not significantly associated with higher frequency of telangiectasia, although there was a trend in this direction.

MeSH terms

  • Adolescent
  • Brain Diseases / diagnosis
  • Brain Diseases / epidemiology
  • Brain Diseases / etiology*
  • Child
  • Child, Preschool
  • Cranial Irradiation / adverse effects*
  • Dose-Response Relationship, Radiation
  • Female
  • Humans
  • Infant
  • Magnetic Resonance Imaging
  • Male
  • Telangiectasis / diagnosis
  • Telangiectasis / epidemiology
  • Telangiectasis / etiology*