胶质瘤手术后放射性脑病和肿瘤复发的临床鉴别分析

Clinical identificational analysis of radiation encephalopathy and tumor recurrence after gliomas operation

目的提高胶质瘤术后放疗导致的放射性脑病和肿瘤复发的鉴别诊断率。方法回顾性分析总结该院近10年来胶质瘤术后经放射治疗,并行第2次手术4800例的患者的临床表现、影像学特征以及术后病理结果等。结果26例患者2次术后经病理切片确诊为放射性脑病。结论胶质瘤术后放射性脑病和复发鉴别较困难,临床上较易误诊。必须综合患者的病史、症状体征、复发时间、放射剂量以及影像学表现等多方面的特征,才能提高鉴别诊断率。

[ Objective ] In order to increase the rate of differential diagnosis between the recurrence of glioma and radiation encephalopathy which occur after the treatment of surgery and radiotherapy with glioma. [Methods]To review and summarize clinical manifestation, imaging feature and pathological results of the 4800 cases with glioma which were performed two operations in the past ten years. [Results] Based on pathological result 26 patients were diagnosed as radial encephalopathy after surgery. [Conclusion] It is quite difficult to make it clear between radiation encephalopathy and the recurrence of glioma and misdiagnosis always occurs. It is contributed to combining with case history, clinical symptoms and signs, the time of recurrence, the dose of radiation and imaging feature in order to increase the rate of correct diagnosis, avoid innecessary surgery again.