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目的探讨脑膜瘤患者伽玛刀治疗后脑白质损伤与患者认知功能的关系。方法 89例接受伽玛刀治疗的脑膜瘤患者在伽玛刀治疗前及治疗后1月、6月,分别进行磁共振检查(FLAIR序列),采用脑白质高信号Schelten评分评估脑白质损伤严重程度;同时以蒙特利尔认知评估量表(MoCA)评定患者认知功能。结果①治疗后1月、6月患者Schelten评分均较治疗前显著增高,差异均有统计学意义(t=4.066,5.376;P=0.000);②治疗后1月、6月患者MoCA评分均较治疗前显著下降,差异均有统计学意义(t=2.370,2.265;P=0.019,0.024);③治疗后1月、6月时患者的Schelten评分与MoCA评分之间有负性相关(r=-0.308,-0.402;P=0.038,0.007)。结论伽玛刀治疗可致脑膜瘤患者脑白质损伤,并与其认知功能的降低有关。
Objective To investigate the relationship between white matter damage and cognitive function in patients with meningioma after gamma knife treatment. Methods Ninety-nine patients with meningiomas undergoing gamma knife radiosurgery were examined by magnetic resonance imaging (FLAIR) before and after gamma knife treatment at 1 month and 6 months after treatment. The severity of white matter damage was assessed using the Schelten score of white matter hyperintensity At the same time, the cognition of patients was assessed by Montreal Cognitive Assessment Scale (MoCA). Results ① The Schelten scores of patients at 1 month and 6 months after treatment were significantly higher than those before treatment (both t = 4.066 and 5.376; P = 0.000); ②The scores of MoCA at 1 month and 6 months after treatment were significantly higher than those before treatment (T = 2.370,2.265; P = 0.019,0.024); ③ There was a negative correlation between Schelten score and MoCA score at 1 month and 6 months after treatment (r = -0.308, -0.402; P = 0.038, 0.007). Conclusion Gamma knife treatment can cause brain white matter injury in patients with meningioma and its cognitive function is reduced.