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目的观察用射波刀立体定向放射治疗脊髓动静脉畸形的疗效。方法对1例Rosemblum分型Ⅱ型脊髓动静脉畸形病人用射波刀进行治疗,放射总剂量25 Gy,每次5 Gy,1次/日,连续5日(25Gy/5f);对1例Ⅲ型者,采用21Gy/2f。治疗前1例行脊髓血管造影检查明确诊断,1例行手术探查明确诊断。治疗前、后定期行脊髓MRI检查,以评估治疗的影像学效果。使用阿米诺夫量表评估治疗前、后脊髓功能的改变。使用脊髓急性放射毒性分级表评估脊髓放射毒性。结果治疗后行10个月、6个月随访,MRI复查脊髓内脊髓动静脉畸形异常信号消失,阿米诺夫量表总分由7分、8分,降至1、0分,均临床显效;而脊髓急性毒性在随访期内均为0级。结论射波刀立体定向放射治疗对Ⅱ型和Ⅲ型脊髓动静脉畸形有效,但长期疗效及脊髓毒性反应尚待观察。
Objective To observe the curative effect of stereotactic radiosurgery for spinal arteriovenous malformations with a radiosurgery. Methods One patient with Rosemblum type Ⅱ spinal cord arteriovenous malformations was treated with radiosurgical knife. The total radiation dose was 25 Gy (5 Gy, once per day) for 5 days (25 Gy / 5 f) Type, using 21Gy / 2f. 1 case before treatment of spinal cord angiography confirmed the diagnosis, a case of surgical exploration to confirm the diagnosis. Spinal cord MRI was performed regularly before and after treatment to evaluate the imaging effect of the treatment. Use the Aminofv scale to assess changes in spinal cord function before and after treatment. Spinal cord radiotoxicity was assessed using the Spinal Cord Acute Radiological Toxicity Scale. Results The patients were followed up for 10 months and 6 months. The anomalous signal of spinal cord arteriovenous malformations disappeared on MRI. The total score of Aminofv was 7 to 8, down to 1, ; Acute spinal cord toxicity in the follow-up period are 0. Conclusion Radiofibrator stereotactic radiotherapy is effective in type Ⅱ and type Ⅲ spinal arteriovenous malformations. However, long-term efficacy and spinal toxicity have yet to be observed.