论文部分内容阅读
目的回顾性分析颅内肿瘤伽玛刀治疗后的影像学表现,为疗效判断提供依据。方法颅内肿瘤227例(良性肿瘤127例,恶性肿瘤100例)中,81例获病理诊断,146例经临床及影像诊断。周边剂量8~25Gy(平均16.7Gy),中心最大剂量16~50Gy(平均25.4Gy)。伽玛刀治疗后定期行CT或MRI复查,影像随访时间为恶性肿瘤3~36个月(平均12个月),良性肿瘤6~42个月(平均28个月)。结果65例脑转移瘤、生殖细胞瘤和淋巴瘤中,肿瘤缩小或消失60例(92.3%),增大5例(7.7%);35例胶质瘤中肿瘤缩小或消失14例(40%),大小不变11例(31.4%),增大10例(28.6%);127例良性肿瘤中肿瘤消失或缩小69例(54.3%),大小不变58例(45.7%)。总有效率为93.4%。伽玛刀治疗后新出现瘤周水肿或原有瘤周水肿加重30例(13.2%),瘤内出血8例(3.5%)。结论伽玛刀治疗颅内肿瘤局部控制率高,并发症少,影像学随访是疗效判断的关键。
Objective To retrospectively analyze the imaging findings of intracranial tumors treated with Gamma Knife to provide the basis for judging therapeutic effect. Methods 227 cases of intracranial tumors (127 cases of benign tumors, 100 cases of malignant tumors), pathological diagnosis of 81 cases, 146 cases of clinical and imaging diagnosis. Peripheral dose 8 ~ 25Gy (average 16.7Gy), the center of the maximum dose of 16 ~ 50Gy (average 25.4Gy). Gamma knife after treatment regular CT or MRI review, imaging follow-up time for malignancies 3 to 36 months (average 12 months), benign tumors 6 to 42 months (average 28 months). Results In 65 cases of brain metastases, germ cell tumors and lymphomas, the tumors were reduced or disappeared in 60 cases (92.3%) and in 5 cases (7.7%). In 35 cases of gliomas, tumors were reduced or disappeared in 14 cases (40% ), Unchanged in 11 cases (31.4%) and increased in 10 cases (28.6%). Of the 127 benign tumors, tumors disappeared or contracted in 69 (54.3%) and unchanged in size in 58 (45.7%). The total effective rate was 93.4%. Gamma knife after treatment of new or peripheral edema around the original peritumoral edema in 30 cases (13.2%), 8 cases of intracranial hemorrhage (3.5%). Conclusion Gamma knife treatment of intracranial tumors with high local control rate, fewer complications, imaging follow-up is the key to determine the efficacy.