低恶度脑胶质瘤伽玛刀术后疗效及放射反应的磁共振研究

MRI research and therapeutic efficacy evaluation for low-grade glioma after gamma knife radiosurgery

目的评价低恶度脑胶质瘤(星形细胞瘤Ⅰ-Ⅱ级)伽玛刀术后疗效,并探讨评价方法,放射反应的特征及其对疗效评价的影响。方法分析52名低恶度胶质瘤伽玛刀术后患者的140份磁共振资料,测量肿瘤大小变化以评价疗效,并研究肿瘤术后放射反应性MRI强化、灶周水肿、坏死囊变的特征及变化。结果总显效率为54.3%,总有效率为84.3%,术后分时间段计算的显效率分别为30%、36.4%、50%、68%、69.2%、73.1%.病灶增大与MRI强化及坏死囊变存在关联。32.7%患者伽玛刀治疗后会出现放射性水肿。57.7%患者出现术后MRI强化,以花边状强化为特征,也可呈斑片状。结论可应用MRI对低恶度胶质瘤伽玛刀术后进行疗效评价,显示其疗效显著。在评价方法上显效率明显优于有效率。显效率随时间而持续递增,以3年以上的远期随访的显效率最高,达73.1%。放射反应对疗效评价有一定影响。术后放射反应性的MRI强化常呈特征性的花边状强化。

Objective To investigate therapeutic efficacy, radiobiological effect and evaluation methods for low-grade glioma after gamma knife radiosurgery.Methods To measure the foeus of 140 eases MRI for 52 low-grade glioma patients after gamma knife radiosurgery and analyze the eharaeter or evolvement of MRI eontrast enhancement, oedema and ruined area, Results The effieieney rate is 84,3 %, The salient effieieney rate is 54,3 % for total and 30 %, 36,4 %, 50%, 68 %, 69,2 %, 73,1% in sort phase of time. Focus widening related to MRI eontrast enhancement and ruined area, Radiobiologieal oedema oeeurs for 32.7 %, The MRI contrast enhancement oceurs for 57,7% and shows special lace-like ring while some piece-like, Conclusion Evaluation by MRI shows gamma knife radiosurgery is efficient for low-grade glioma, The salient effieieney rate that increase with time is good for evaluation than the efficiency rate espeeialy for Long-term MRI follow, Radiobiologieal effect affect the efficacy evaluation, MRI contrast enhancement shows special lace-like ring.