摘要
目的评估伽玛刀(γ-刀)对脑动静脉畸形(AVM)的治疗效果及影响因素。方法抽取72例上海伽玛刀医院于1994～1995年应用γ-刀治疗的AVM病例,回顾性分析其疗效和影响因素,探讨治疗适应证,周边剂量等。结果本组AVM直径<3cm45例,3～6cm27例;平均周边剂量20.6Gy。其中51例行血管造影等影像学随访,AVM完全闭塞率为56.9%;体积<10ml,周边剂量大于20Gy组完全闭塞率较高。头痛、癫痫的缓解率达81.8%。6例于γ-刀治疗后发生自发性脑出血。γ-刀治疗后的AVM闭塞情况和并发症的发生与病灶体积、治疗周边剂量、随访时间等因素有关。结论γ-刀是治疗脑AVM的一种较安全、较有效的治疗方法。体积<10ml,位于功能区或部位深在的AVM是适合γ-刀治疗的病例,周边剂量以20～25Gy为宜。
Objective To evaluate the effects of gamma knife radiosurgery on cerebral arteriovenous malformations(AVMs).Method72patients with cerebral AVMs,treated with Leksell gamma knife radiosurgery at the Shanghai Gamma Knife Hospital during the period from1994to1998,were retrospectively reviewed in order to analyze the therapeutic results and their influence factors.And the indication of gamma knife radiosurgery,as well as the peripheral dose,was also discussed.Result The diameter of45AVMs was less than3cm,and that of the others was between3cm and6cm.The mean peripheral dose was20.6Gy.The follow-up imaging examinations of the51cases demonstrated that complete nidus obliteration was attained in56.9%.The AVMs with volumes of less than10ml irradiated with more than20Gy of the peripheral dose had a higher complete obliteration rate.The symptoms of headache or epilepsy improved in81.8%.Six patients suffered spontaneous intracerebral hemorrhages during the follow-up period.The obliteration rate and postradiosurgical complications of the AVMs treated with the gamma knife radiosurgery were related to the target volume,the peripheral dose,and the method of localization.Conclusion The gamma knife radiosurgery is an effective and safe treatment for AVMs of the brain.It is especially suitable for treatment of the AVMs with a volume of less than10ml,or AVMs involving in the functional area or the deep-seated AVMs.The recommended peripheral dose is between20and25Gy.
出处
《中国微侵袭神经外科杂志》
CAS
2002年第4期210-213,共4页
Chinese Journal of Minimally Invasive Neurosurgery
