听神经瘤伽玛刀术后的影像学表现  

Acoustic Neurinoma:Imaging Findings After Gamma Knife Treatment

作　　者：梁辉顺[1,2] 戴嘉中[1,2] 蔡佩武 陈星荣[1,2] 

机构地区：[1]福建医科大学附属协和医院MR室 [2]上海医科大学附属华山医院放射科

出　　处：《实用放射学杂志》1998年第12期710-713,共4页Journal of Practical Radiology

摘　　要：目的：探讨伽玛刀治疗听神经瘤后的影像学表现。方法：回顾研究５８例行伽玛刀治疗后随访时间在１２～２６个月（中位数１８个月）的听神经瘤病人。结果：伽玛刀术后肿瘤内坏死无强化率为６２．５％，其中１６．１％复强化。术后脑积水的发生率为１４．３％，肿瘤平均直径＜２ｃｍ患者中无一发生术后脑积水。桥脑或／或小脑水肿的发生率为５．２％。卡方检验示术前肿瘤平均直径与术后脑积水有统计学意义（Ｐ＜０．０１），部分患者术后发生脑积水和／或肿瘤内坏死，两者经卡方检验有统计学意义（Ｐ＝０．０１）。结论：肿瘤内坏死无强化为术后特征性的影像学表现，术后并发症在影像上表现为脑积水及桥脑和／或小脑水肿。术后脑积水的发生率随术前肿瘤平均直径增大而升高。ObjectiveTo evaluate the imaging features after gamma knife treatment on acoustic neurinomas.Methods:We reviewed 58 patients whom follow-up ranged from 12 to 26 months(media,18 month) with acoustic neuriomas treated by gamma knife.Reselt:The rate of necrosis and non contrast enhancement in tumor was 62.5%,16.1% of which was re-enhanced after treatment.The rate of hydrocephalus developed in 14.3% of patients.No hydrocephalus developed in those patients with average tumor diameter less than 2 cm.In 5.2% of patients,delayed edema developed in the pons and /or cerebellar.Chi-square test analyses revealed that the risk of delayed hydrocephalus was significantly associated with the tumor average diameter(P<0.01).Some patients developed postoperative hydrocephalus and/or the necrosis of tumor,the hydrocephalus was significantly associated with the necrosis of tumor(P=0.01).Conclusion:The necrosis and uncontrast enhancement of tumor are postoperative characteristic imaging findings.The postoperative complications are hydrocephalus and edema in pons and/or cerebellar.The incidence of postoperative hydrocephalus is increased with increasing preoperative tumor average diameter.The postoperative hydrocephalus may be in relation to the necrosis of tumor.

关 键 词：伽玛刀 听神经瘤 X线诊断 CT NMR 成像 

分 类 号：R739.430.5[医药卫生—肿瘤] R730.55[医药卫生—临床医学]