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目的探讨不同部位脑外伤后癫痫γ射线治疗剂量。方法取自我院2004年5月到2009年4月共计48例患者,采用日立AIRISII0.3Tesla永磁MR扫描仪,西门子Biograph-16 PET联合定位诊断。采用玛西普公司旋转式头部γ刀治疗仪。结果 47例患者,颞叶单纯发作,采取边缘剂量15～20Gy,等中心曲线40%～60%,50%剂量曲线包围大于致癫灶的有效范围约10mm,额叶病灶边缘剂量10～15Gy,等中心曲线40%～60%,50%剂量曲线包围大于致癫灶的有效范围约10mm,顶叶病灶边缘剂量8～16Gy,等中心曲线40%～60%,50%剂量曲线包围大于致癫灶的有效范围约10mm,复杂性部分发作患者给予上述剂量的1.2～1.5倍,全身性发作患者给予上述剂量的1.5～2.5倍,对于颞叶病灶或额颞叶同时受累及的病灶,杏仁核,边缘剂量25～30Gy,采用8mm准直器;胼胝体、扣带回和内囊前肢中心剂量75～100Gy,采用4mm准直器,均为50%等剂量曲线。结论不同部位病灶存在着最佳剂量范围采用最佳剂量治疗,可以提高疗效。
Objective To investigate the dose of γ ray treatment for epilepsy after traumatic brain injury in different parts. Method from our hospital from May 2004 to April 2009 a total of 48 patients, using Hitachi AIRISII0.3Tesla permanent magnetic resonance MR scanner, Siemens Biograph-16 PET joint positioning diagnosis. Ma Xi Pu company using the rotary head gamma knife treatment instrument. Results In 47 patients, the temporal lobe was only attacked with a dose of 15-20 Gy and an isocentrism curve of 40-60%. The 50% dose curve encircled the effective range of the epileptogenic zone by about 10 mm and the marginal dose of the frontal lobe was 10-15 Gy. The isocenter curve is 40% -60%, the 50% dose curve is larger than the effective range of the epileptogenic zone, the marginal dose of the parietal lobe is 8-16Gy, the isocenter curve is 40% -60%, and the 50% dose curve is larger than the epileptogenic The effective range of the stove is about 10mm, patients with complicated partial seizures are given 1.2 to 1.5 times of the above dosage, patients with generalized seizures are given 1.5 to 2.5 times of the above dosage, and for lesions involving both temporal lobe lesions and frontal and temporal lobes, the amygdala , The marginal dose of 25 ~ 30Gy, using 8mm collimator; corpus callosum, cingulate gyrus and the central foreleg of the internal capsule dose 75 ~ 100Gy, using 4mm collimator, were 50% isodose curve. Conclusion The optimal dose range exists in different parts of the lesions using the best dose of treatment, can improve the curative effect.