【摘要】 目的比较伽玛刀治疗前与治疗后1个月脑肿瘤实质标准化表观扩散系数(nADC)值的变化,研究扩散加权成像(DW I)早期评价脑肿瘤伽玛刀治疗效果的价值,为临床诊断治疗提供更可靠的方法和依据。资料与方法选择27例患者31个病灶作为研究对象,详细了解患者一般情况。在伽玛刀治疗前1天及治疗后1个月分别行常规MR I及DW I检查。在肿瘤实质区及对侧相应或邻近部位正常白质选取3~5个兴趣区,计算肿瘤实质的nADC值,比较伽玛刀治疗前后脑肿瘤实质nADC值的变化,并与肿瘤最大直径的变化比较。结果脑转移瘤、垂体瘤伽玛刀治疗后1个月肿瘤实质的nADC值较治疗前明显升高(P<0.05),脑转移瘤最大直径缩小,垂体瘤直径未见明显变化;胶质瘤、脑膜瘤、血管母细胞瘤、神经纤维瘤的nADC值伽玛刀治疗后未见明显升高(P>0.05),肿瘤直径亦未见明显缩小。结论肿瘤实质的nADC值能够早期较好地评价脑肿瘤的伽玛刀治疗效果,同时,nADC值能够较好地鉴别脑肿瘤的良恶性。但是应用nADC鉴别肿瘤类型仍需进一步研究。更多还原

【Abstract】 Objective The nADC of brain tumor 1 month after Gamma Knife Surgery(GKS) were compared with that before GKS.And the change were analysed quantitatively in order to discuss the value of DWI in assessment of treatment response of GKS for brain tumor.The final purpose was to provide a new and credible method for diagnosis and treatment of brain tumors.Materials and Methods There were 31 lesions in 27 patients in the study.The conventional MRI and DWI examinations were taken 1 day before and 1 month after Gamma Kinfe treatment,and all images were sent to work station to analyse the ADC map through selecting 3 to 5 ROIs located in tumor parenchyma and white matter in corresponding area of contralateral cerebral hemisphere.The value of nADC in tumor parenchyma before and after the treatment was analyzed,and the change in nADC was compared with the change in tumor size measured in enhance T1WI images.Results The nADC in metastasis and pituitary adenoma was significantly higher 1 month after GKS compared with that before GKS(P<0.05),accompany with the diameter of metastasis reducing,but the diameter of pituitary adenoma change little.The nADC in glioma,meningioma,hemangioblastoma and neurofibroma after GKS was not showed obviously changing(P>0.05),and the diameter of these tumors was not showed reducing either.Conclusion Changes of nADC mearured by DWI can well predict treatment response of GKS early,meanwhile,the nADC is helpful in identification of benign and malignant tumors.更多还原