CAJ | 학술논문

目的：探讨脑电图在非颅内肿瘤所致放射性脑病（REP）患者的临床应用价值。方法18例非颅内肿瘤患者接受放射线治疗后，进行脑电图、头颅MRI检查。采用回顾性分析，进行脑电图异常脑波出现范围及定位与头颅MRI放射性病灶范围及定位的比较，并根据MRI结果分为MRI阳性组和阴性组。结果18例放射性脑病患者中，9例头颅MRI阴性，9例头颅MRI阳性。两组患者的脑电图和头颅MRI检查比较，影像学阴性组患者脑电图异常脑波出现的平均导联数为11，异常脑波以θ波为主。影像学阳性组患者MRI病灶平均体积为35.2cm3，脑电图异常脑波以δ波为主，且无论MRI单侧病灶或双侧病灶，异常脑波的出现均为双侧，病灶侧为重；1例患者出现尖慢复合波。全部患者的异常脑波出现率为100%。上述数据表明，患者头颅MRI尚未发现明确放射性病灶时，脑电图即可检出慢波增多，程度多为轻度，少数为中-重度；患者头颅MRI已发现明确病灶时，仅有极少数患者脑电图为轻度异常，多数患者为中等程度至重度异常，而且常表现为异常脑电波全导联同步发放，出现异常脑电波的导联范围往往明显超出MRI病灶范围。证明脑电图异常改变的出现早于影像学异常。结论放射性脑病患者的脑电图异常改变的出现早于影像学异常改变，因此临床上应用脑电图检查，有早期预测价值，早期脑电图检查对放射性脑病患者的早诊断、早干预、早治疗提供重要的依据。
목적：탐토뇌전도재비로내종류소치방사성뇌병（REP）환자적림상응용개치。방법18례비로내종류환자접수방사선치료후，진행뇌전도、두로MRI검사。채용회고성분석，진행뇌전도이상뇌파출현범위급정위여두로MRI방사성병조범위급정위적비교，병근거MRI결과분위MRI양성조화음성조。결과18례방사성뇌병환자중，9례두로MRI음성，9례두로MRI양성。량조환자적뇌전도화두로MRI검사비교，영상학음성조환자뇌전도이상뇌파출현적평균도련수위11，이상뇌파이θ파위주。영상학양성조환자MRI병조평균체적위35.2cm3，뇌전도이상뇌파이δ파위주，차무론MRI단측병조혹쌍측병조，이상뇌파적출현균위쌍측，병조측위중；1례환자출현첨만복합파。전부환자적이상뇌파출현솔위100%。상술수거표명，환자두로MRI상미발현명학방사성병조시，뇌전도즉가검출만파증다，정도다위경도，소수위중-중도；환자두로MRI이발현명학병조시，부유겁소수환자뇌전도위경도이상，다수환자위중등정도지중도이상，이차상표현위이상뇌전파전도련동보발방，출현이상뇌전파적도련범위왕왕명현초출MRI병조범위。증명뇌전도이상개변적출현조우영상학이상。결론방사성뇌병환자적뇌전도이상개변적출현조우영상학이상개변，인차림상상응용뇌전도검사，유조기예측개치，조기뇌전도검사대방사성뇌병환자적조진단、조간예、조치료제공중요적의거。
Objective To explore the clinical application of EEG in patients with radiation encephalopathy caused by non-intracranial tumors. Methods Retrospectively analyze 18 cases of non-intracranial tumor patients who received EEG and cranial MRI (magnetic resonance imaging) after radiation therapy for non-intracranial tumors, to analyze the positioning and scope of regions with abnormal EEG waves and the localization and scope of radiation lesions in cranial MRI. The patients were divided into MRI-negative and -positive groups according to the MRI results. Results Among the 18 cases of radiation encephalopathy patients, 9 cases were MRI-negative, and 9 were positive. Comparison of the results of EEG and cranial MRI between the 2 groups indicated that the average number of leads in EEG waves among MRI-negative patients was 11, and the abnormal EEG appeared as θ-wave-based. The average volume of MRI lesion in MRI-positive patients was 35.2cm3, and the abnormal EEG waves were δ-wave-based. Regardless of MRI unilateral or bilateral lesions, abnormal EEG waves appeared bilaterally, but severer in ipsilateral side. One patient showed sharp slow complex wave. The occurrence rate of abnormal EEG among all patients was 100%. The above data indicated that when cranial MRI was unable to show clear radiation lesion in patients, EEG detected the increase in slow waves, most of which are mild, while a small number was medium-severe;when MRI indicated clear lesions, EEG in only a handful of patients displayed mild abnormality, while majority of patients showed moderate even severe abnormalities in EEG, which often manifesting as full-lead simultaneous discharge of abnormal waves, and the scope of regions showing abnormal EEG waves often significantly exceeded that of MRI lesions, demonstrating that abnormal EEG changes appeared earlier then those on MRI. Conclusion The abnormal EEG changes in patients with radiation encephalopathy appeared earlier than radiographic abnormalities. Therefore, clinical application of EEG may have early predictive value, and early EEG examination may provide important basis for early diagnosis, early intervention, and early treatment of patients with radiation encephalopathy caused by non-intracranial tumors.