海绵窦海绵状血管瘤伽玛刀分次治疗的效果分析

Efficacy analysis of fractionated gamma knife treatment for cavernous sinus cavernous hemangiomas

目的探讨伽玛刀分次治疗海绵窦海绵状血管瘤(CH)的效果。方法回顾性分析11例海绵窦CH的临床资料。肿瘤MRI特点:T_1WI呈低或略等信号,T_2WI呈均匀高信号,增强扫描肿瘤均匀强化,肿瘤直径40～78 mm。行Leksell伽玛刀6～8个月内分次治疗方案,首次伽玛刀治疗肿瘤中心剂量25 Gy,平均边缘剂量9 Gy;第二次治疗中心剂量30 Gy,边缘15 Gy。结果随访6～48个月,平均36个月。病人均未出现新的脑神经受损症状,原有症状均不同程度改善。影像学结果:伽玛刀术后6～12个月肿瘤基本消失2例,明显缩小9例。结论伽玛刀分次治疗海绵窦CH疗效良好疗效。

Objective To investigate the effects of fractionated gamma knife treatment for cavernous sinus cavernous hemangiomas（CHs）. Methods Clinical data of 11 patients with cavernous sinus CHs were analyzed retrospectively. The MRI characteristics of the tumors were as follows： T_1WI showed hypointensity or isointensity, T_2WI showed homogeneous hyperintensity, and enhanced scan showed homogenous enhancement. The maximum diameter of the tumors was 78 mm and the minimum was 40 mm. Fractionated Leksell gamma knife treatment ranging from 6 to 8 months was performed in all the patients. During the first treatment, the radioactive dose of tumor core was 25 Gy and the average dose of the tumor margin was 9 Gy. During the second treatment, the radioactive dose of the core was 30 Gy, and the average dose of the tumor margin was 15 Gy. Results The mean follow-up period was 36 months,ranging from 6 to 48 months. No patients showed any new cranial nerve deficits, and the initial symptoms were improved to different degrees. The tumor almost disappeared in 2 patients and significantly shrank in 9 in 6 to 12 months after gamma knife treatment based on the imaging finding. Conclusion Fractionated gamma knife treatment is well effective for cavernous sinus CHs.