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目的:分析脑膜瘤伽玛刀治疗后的影像学变化规律。方法:回顾分析58例单发脑膜瘤伽玛刀单次治疗后的影像学资料。治疗前肿瘤容积为0.88～35.90ml,平均10.57ml;治疗中心剂量为22.5～40Gy,平均29.04Gy;边缘剂量为10～20Gy,平均14.27Gy。等剂量线为40%～60%,平均49.43%。等中心数目2～16个,平均9.24。结果:治疗后随访6～34个月,平均14.31个月,其中23例容积缩小,30例容积无变化,5例容积增大;31例中心强化减低,12例肿瘤边界模糊。术后出现瘤周水肿19例,其中症状性瘤周水肿7例,非症状性瘤周水肿12例。7例症状性瘤周水肿影像学检查均为弥漫性瘤周水肿,12例非症状性瘤周水肿患者影像学检查4例为弥漫性瘤周水肿,8例为局限性瘤周水肿。结论:脑膜瘤伽玛刀治疗后的影像学检查既可动态观察肿瘤容积变化以确定疗效,又可及时发现瘤周水肿及早予以治疗。
OBJECTIVE: To analyze the imaging changes of meningioma after gamma knife treatment. Methods: Fifty-eight cases of single meningioma with gamma knife radiofrequency imaging were retrospectively analyzed. The tumor volume before treatment was 0.88-35.90ml, with an average of 10.57ml. The treatment center dose was 22.5-40Gy with an average of 29.04Gy. The marginal dose was 10-20Gy with an average of 14.27Gy. Isodose line is 40% to 60%, an average of 49.43%. The number of centers is 2 to 16, with an average of 9.24. Results: After treatment, the patients were followed up for 6 to 34 months with an average of 14.31 months. Among them, 23 patients had a decrease in volume, 30 patients had no change in volume and 5 patients had an increase in volume. There were 19 cases of peritumoral edema after surgery, including 7 cases of symptomatic peritumoral edema and 12 cases of non-symptomatic peritumoral edema. Seven cases of periventricular edema imaging examination were diffuse peritumoral edema, 12 cases of non-symptomatic peritumoral edema in patients with imaging examination of 4 cases of diffuse peritumoral edema, 8 cases of peritumoral edema. Conclusion: The imaging examination of meningioma after gamma knife treatment can not only dynamically observe the changes of tumor volume to confirm the curative effect, but also treat peri-tumor edema as soon as possible.