CAJ | 학술논문

目的总结海绵窦海绵状血管瘤(CSHAs)的影像学特点,分析伽玛刀(γ刀)治疗的疗效.方法回顾性分析长期随访的16例应用ELEKTA Leksell γ刀治疗CSHAs的临床资料,其中6例为术后残留,2例仅术中活检,8例根据典型的影像学表现及后期随访诊断.肿瘤最大径为15.0～ 55.0 mm,平均34.6 mm,治疗周边剂量为8.0～15.0 Gy,平均12.1 Gy,等剂量曲线40％～60％,中心剂量16.0～32.5 Gy,平均24.3 Gy,随访时间6-96个月,平均40.5个月.结果 γ刀治疗后所有患者均未出现新的永久性脑神经受损症状,其中2例在术后3-6个月左右出现短暂的轻度动眼神经麻痹症状.影像学结果:4例肿瘤几乎消失,10例明显缩小,2例变化不明显,无增大病例,其中1例于6个月后再次γ刀治疗(剂量分割),2例于术后2年因缩小不明显再次γ刀治疗,后期随访均明显缩小.结论 Leksellγ刀治疗CSHAs安全可靠,疗效满意.γ刀是治疗术后残留、中小型(最大径≤40 mm)及不能耐受手术CSHAs的有效方法之一.
목적 총결해면두해면상혈관류(CSHAs)적영상학특점,분석가마도(γ도)치료적료효.방법 회고성분석장기수방적16례응용ELEKTA Leksell γ도치료CSHAs적림상자료,기중6례위술후잔류,2례부술중활검,8례근거전형적영상학표현급후기수방진단.종류최대경위15.0～ 55.0 mm,평균34.6 mm,치료주변제량위8.0～15.0 Gy,평균12.1 Gy,등제량곡선40％～60％,중심제량16.0～32.5 Gy,평균24.3 Gy,수방시간6-96개월,평균40.5개월.결과 γ도치료후소유환자균미출현신적영구성뇌신경수손증상,기중2례재술후3-6개월좌우출현단잠적경도동안신경마비증상.영상학결과:4례종류궤호소실,10례명현축소,2례변화불명현,무증대병례,기중1례우6개월후재차γ도치료(제량분할),2례우술후2년인축소불명현재차γ도치료,후기수방균명현축소.결론 Leksellγ도치료CSHAs안전가고,료효만의.γ도시치료술후잔류、중소형(최대경≤40 mm)급불능내수수술CSHAs적유효방법지일.
Objective To summarize the imaging characteristic of cavernous sinus cavernous hemangiomas(CSHAs),and evaluate the effects of Gamma Knife Radiosurgery (GKS) on CSHAs.Methods The clinical date of 16 patients with CSHAs were analyzed retrospectively,all cases were treated by GKS and with complete follow - up data in our hospital from September 2001 to December 2009.Of the 16 patients,6 had residual tumor after surgery,2 were biopsied,and 8 were diagnosed by neuroradiology and follow - up data in recent years.The mean maximum diameter of tumors was 34.6 mm ( ranged 15.0 ～ 55.0 mm ),the mean tumor margin dose was 12.1 Gy ( ranged 8.0 ～ 15.0 Gy) at the isodose line from 40％ to 60％,the mean max dose was 24.3 Gy( ranged 16.0 ～32.5 Gy).The mean follow - up period was 40.5 months ( ranged 6 -96 months).Results No patients suffered from a new and eternal cranical never deficit after GKS treatment.2 patients suffered from transient oculomotor palsy among 3 months and 6 months.Imaging findings revealed:of the 16 tumors,4 almost disappeared,10 decreased markedly in size and 2 kept stable.1 patient was treated again by GKS after 6 months,and 2 patients were treated again for tumors decreased not remarkable in size,these tumors all decreased markedly in follow -up.Conclusion GKS treatment can effectively control tumor growth with mild side - effects.It is one of the best treatment for postoperative tumor residual,small and middle - size CSHAs,or for patients who are not suitable for craniotomy.