伽玛刀治疗海绵窦海绵状血管瘤的疗效分析(附19例报道)

目的 探讨伽玛刀治疗海绵窦海绵状血管瘤的临床疗效。方法 回顾性分析2005 年10月至2014年10月应用伽玛刀进行治疗的19例海绵窦海绵状血管瘤的临床资料；采用50%等剂量曲线覆盖肿瘤周边，平均周边剂量为13 Gy，平均中心剂量25.2 Gy；治疗后随访6~93个月，平均为40.2个月。结果 肿瘤最大径为22~65 mm，平均41 mm，肿瘤平均体积为25.5 cm3。治疗后，所有病人均未出现新的神经功能受损症状，影像学缩小50%以上9例，缩小25%~50%3例，缩小25%以下2例，无变化5例。头痛10例中，改善6例；面部感觉减退7例中，改善5例；视力下降11例中，改善7例；复视8例全部改善。结论 伽玛刀治疗海绵窦海绵状血管瘤安全有效，有良好的控制作用，并可有效地改善临床症状。

Curative effects of gamma knife radiosurgery on cavernous sinus hemangiomas (report of 19 cases)

Objective To analyze the therapeutic effects of gamma knife radiosurgery on cavernous sinus cavernous hemangiomas (CSCH). Methods The clinical data of 19 patients with CSCH treated by gamma knife radiosurgery in Tangdu Hospital of The Fourth Military Medical University from October, 2005 to October, 2014 were analyzed retrospectively. The maximum diameters of CSCH ranged from 22 to 65 mm (mean, 41 mm) and the mean volume of CSCH was 25.5 cm3. The 50% iso-dose curve was used to cover the periphery of CSCH and the average peripheral dose was 13 Gy. All the patients were followed up from 6 to 63 months (mean, 40.2 months). Results No new neurological deficit was observed in all the patients after the gamma knife radiosurgery. The neuroimaging examination showed that the volume of CSCH decreased more than 50% in 9 cases, 25%~50% in 3, less than 25% in 2, and was unchanged in 5. The headache was improved in 6 cases (60%, 6/10), the facial sensory disturbance in 5 (71.4%, 5/7), visual power in 7 (63.6%, 7/11), and diplopia in 8 (100%, 8/8). Conclusion Gamma knife radiosurgery is a safe and effective method to treat CSCH.