摘要
目的 探讨放射性脑坏死的影像学特点及治疗方法。方法 对7例颅内肿瘤术后行放射外科或普通外照射治疗后发生放射性脑坏死的患者的临床及影像学资料进行回顾性分析。结果放射性脑坏死的临床表现与同一部位的肿瘤相似。而影像学表现与肿瘤截然不同，MRI常为带有“锯齿状或棘角状外突”的“地图样”周边强化及周围水肿，没有强化结节。MRS为NAA及Cho／Cr下降。3例经手术及病理证实为脑坏死。另4例依据其特有的影像学表现明确诊断，应用皮质类固醇及脱水剂治疗，经半年MRI随访，病灶稳定或缩小，其周围水肿明显减轻。结论大多数患者通过MRI、MRS检查能够明确诊断，通常应首选保守治疗，只在肿瘤复发不能排除或颅内压很高时采用手术治疗。
Objective To investigate the imaging features and treatment of brain radionecrosis. Methods The clinical and imaging data were analyzed retrospectively in 7 patients with intracranial tumor who were treated by stereotactic radiosurgery or external beam radiotherapy and the radiation necrosis of brain happened con- sequently. Results The clinical manifestations of brain radionecrosis were similar to tumor of same position, but the imaging features were completely different from the tumor. Characteristic imaging findings in radionecrosis were map - like enhancement of accompaning sawtooth or horn - like protrusion and perilesional edema without enhancement nodule in MRI, NAA and Cho/Cr reduced in MRS. The operation Was performed because of doubting tumor recurrent in 3 patients. The pathology diagnosis is necrosis. Other 4 cases were administrated corticosteroid and dehydrant based on specific findings of imaging. The size of focus was stationary or reductive and perilesional edema reduced markedly by MRI followed - up for half year. Conclusion The brain radio necrosis can be diagnosed by MRI,MRS. Examinations in majority cases. Conservative treatment is the first selection usually. The operation should be carried out, only when recurrent tumor can not be excluded or intracranial pressure is very high.
出处
《中原医刊》
2008年第7期43-45,共3页
Central Plains Medical Journal
关键词
放射性脑坏死
颅内肿瘤
诊断
治疗
Radiation necrosis
Intracranial tumor
Diagnosis
Treatment
