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目的：探讨伽玛刀治疗后晚发灶周水肿的原因，从而为临床预防及治疗提供依据。材料与方法：伽玛刀治疗后不同程度晚发灶周水肿患者２２例，临床资料齐全及影像资料完整，其中转移瘤２例，胶质瘤７例，脑膜瘤５例，血管畸形７例，帕金森氏病１例（其中４例为院外作伽玛刀治疗），３例用了ＭＲＡ复查（院外），全部病例术前ＭＲＩ图像上均无明显水肿。于治疗后２～１２个月行ＭＲＩ复查。灶周水肿程度分为轻、中、重度。结果：轻度水肿５例，其中胶质瘤４例，转移瘤１例；中度水肿８例，其中血管畸形４例，胶质瘤３例，转移瘤１例；重度水肿９例，其中脑膜瘤５例，血管瘤３例，帕金森氏病１例。结论：产生灶周水肿的原因是多方面的，与病灶大小及照射剂量似有一定关系。笔者根据一些特定部位及血管畸形治疗后易发生水肿的特点，提出可能与损伤邻近的引流静脉导致回流障碍及照射后组织坏死吸收引起自身免疫有关
Objective: To investigate the reason of edema of late perifocal foci after gamma knife treatment, so as to provide the basis for clinical prevention and treatment. MATERIAL AND METHODS: Twenty-two patients with late-stage perifocal edema were treated with Gamma Knife. The clinical data were complete and the imaging data were complete. Among them, 2 were metastases, 7 were gliomas, 5 were meningioma, 7 were vascular malformations, One patient had Parkinson’s disease (4 patients were treated with Gamma Knife outside the hospital), 3 patients had MRA (out-of-hospital), and no edema was found in all the patients’ preoperative MRI images. MRI was performed 2 to 12 months after treatment. Perifocal edema is divided into mild, moderate and severe. Results: 5 cases of mild edema, including 4 cases of glioma, 1 case of metastatic; moderate edema in 8 cases, including vascular malformation in 4 cases, 3 cases of glioma, 1 case of metastatic; severe edema in 9 cases, including the meninges 5 cases of tumor, 3 cases of hemangioma and 1 case of Parkinson’s disease. Conclusion: There are many causes of perifocal edema, which may be related to the size of the lesion and the dose of irradiation. The author according to some specific sites and vascular malformations prone to edema characteristics, proposed may be adjacent to the injury of the drainage veins lead to reflux disorders and tissue necrosis after irradiation caused by autoimmune