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目的对脑转移瘤患者放疗前后进行FAIR技术成像,观察肿瘤血流灌注的变化情况。方法收集接受头部颅脑X-刀联合全脑照射治疗的肺癌脑转移患者33例,各病例均有病理证实,分别于治疗前3天内、治疗后第1天、1周、1个月、3个月、6个月进行常规MR检查及FAIR检查,观察肿瘤灌注图的变化情况,比较放疗前后肿瘤区血流灌注的变化。结果36个病灶中,FAIR可以观察到肿瘤有异常灌注的肿瘤有15个,其中呈均匀强化肿瘤8个,环形强化肿瘤7个。余21个病灶中FAIR图像与正常脑组织无差异,其中5个病灶呈均匀强化,直径在1cm以下,而余下16个环形强化的病灶FAIR图像未见肿瘤异常灌注。结论FAIR技术可以用来观察脑转移瘤放疗前后血流灌注的动态变化,为疗效的判定提供了新的思路。
Objective To evaluate the changes of tumor perfusion in patients with brain metastases before and after radiotherapy by FAIR imaging. Methods Thirty-three patients with brain metastases of lung cancer who underwent craniocerebral X-knife combined with whole brain irradiation were enrolled in this study. All the cases were confirmed by pathology. The changes were observed within 3 days before treatment, 1 day, 1 week, The routine MR examination and FAIR examination were performed at 3 months and 6 months. The changes of tumor perfusion maps were observed. The changes of perfusion in tumor area before and after radiotherapy were compared. Results Among the 36 lesions, FAIR showed 15 tumors with abnormal perfusion, including 8 uniformly enhanced tumors and 7 circumscribed tumors. Among the remaining 21 lesions, there was no difference between FAIR and normal brain tissue. Among them, 5 lesions showed uniform enhancement with a diameter of less than 1 cm, while the remaining 16 lesions showed no abnormal tumor perfusion in the FAIR images. Conclusions FAIR technique can be used to observe the dynamic changes of blood perfusion in brain metastases before and after radiotherapy, providing a new idea for judging the curative effect.