【摘要】 目的:总结海绵窦海绵状血管瘤(CHCS)的MRI特点和射波刀治疗经验。方法:应用射波刀治疗CHCS26例,2例为术后残留,其余24例为影像学诊断。肿瘤的MRI特点:肿瘤边界清晰,T1WI上呈低或略等信号,T2WI和Flair像上呈均匀的高信号,增强时肿瘤可为均匀强化(小肿瘤)、先边缘强化或早期不均匀强化稍延时均匀强化(大肿瘤)。26例肿瘤平均体积为28.9 cm3。1例肿瘤照射1次,3例照射2次,其余22例肿瘤照射3次。随访时间为12~46个月(平均22个月)。结果:5例肿瘤缩小90%以上,9例缩小50%以上,10例缩小约30%,2例略缩小。23例有脑神经受损症状,治疗后7例完全缓解,13例部分缓解,3例无明显改善;所有患者均未出现新的脑神经受损症状。结论:CHCS的射波刀治疗疗效好,不良反应轻。更多还原

【Abstract】 Purpose: To summarize the characteristic MRI fndings of cavernous hemangiomas of the cavernous sinus(CHCS) and evaluate the effect of cyberknife treatment on these lesions.Methods: Between December 2007 and December 2010,26 patients with CHCS were treated by cyberknife.Of the 26 patients,2 were with residual tumor after surgery,24 were diagnosed by neuroradiology.There were 8 male and 18 female patients with mean age of 54 years old.The MR images of the tumors showed hypointensity or isointensity on T1-weighted images and well-defned,homogeneous hyperintensity on T2-weighted and FLAIR images.On contrast-enhanced T1-weighted images,small tumors were homogeneously and densely enhanced,large tumors were heterogeneously enhanced or homogeneously and densely enhanced in delayed scanning.The volume of the tumors ranged from 2.9 to 96.2 cm3,with mean 28.9 cm3.Margin dosage irradiated by cyberknife ranged from 18.0 to 21.0 Gy(maxuimum dose: 28-32 Gy) in 22 tumors in 3 fractions,from 17.8 to 19.0 Gy(maximum dose:27.8-29.2Gy) in 3 tumors in 2 fractions,13 Gy(maximum dose: 20Gy) in 1 tumor in 1 fraction.Follow-up duration was 12-46 months with a mean of 22 months.Results: Follow-up imaging demonstrated that tumor decreased more than 90% in volume in 5 patients,more than 50% in volume in 9 patients,about 30% in volume in 10 patients after the cyberknife treatment.Two tumor kept stable,because of short follow-up duration.Symptoms like slight headache,ptosis of the eyelid and diplopia in 23 patients without open surgery were improved in 13 patients or disappeared in 7 patients after the cyberknife treatment.None of these patients showed any deterioration in symptoms after radiosurgery.No brain edema happened and no cranial nerve defcits developed after cyberknife treatment,although most of these tumors were large or giant.Conclusion: Our experience demonstrated that fractionated cyberknife radiosurgery is safe and is an excellent alternative treatment for patients who have a clear neuroimaging diagnosis of CHCS.更多还原