目的评估旋转式伽玛刀（γ-刀）治疗颅内疾病的临床疗效。方法用1.5T GE MRI定位，以2~3mm的层厚扫描获得定位图像，用Super Plan 2.5/3.0治疗计划系统设计治疗方案，设靶点1~13个，以35%-75%的等剂量曲线包绕靶区，周边剂量为8-98GY，以Masep新一代旋转式伽玛刀做治疗，2002年3月至2012年10月共收治2783例颅内疾病患者，其中2205例获完整随访，男1212例，女993例。结果随访时间为3~127个月，平均58.30个月。伽玛刀治疗各种颅内疾病有效率为：良性肿瘤88.57%（922/1041），恶性肿瘤83.59%（494/591），脑血管畸形85.92%（360/419），功能性疾病85.06%（131/154），5例于伽玛刀术后因脑水肿或肿瘤复发而行手术开颅减压或切除肿瘤，12例因病灶太大或多发病灶而行2~5次伽玛刀治疗。结论旋转式伽玛刀对颅内良、恶性肿瘤及脑血管畸形、功能性疾病有明确疗效，已成为神经外科重要治疗手段。%Objective To evaluate the effects of gamma knife radiosurgery in intracranial diseases. Methods The 2-3mm slice thickness images were performed by GE 1.5T MRI scanners, and dosage planning was made using Super Plan 2.5/3.0 system, marginal does were ranged from 8 to 98Gy with isdose lines ranged from 35%-75%, the isocenters ranged from 1 to 13, treated with Masep new style rotating gamma knife. During March 2002 to October 2012, 2783 patients with intracranial diseases were treated in our center, and 2205 patients, containing 1212 male and 993 female, integrated followed up were enrolled in the study. Results The following up duration was 3 months to 127 months(average 58.30 months) afterγ-knife treatment. The effective rate ofγ-knife treatment in different diseases was follows:benign tumors 88.57%(922/1041), malignant tumors 83.59%(494/591), cerebrovascular malformations 85.92%(360/419), functional diseases 85.06%(131/154). Five patients were performed craniotomy for cerebral edema decompression or recurrent tumor resection.And 12 patients were treated 2-5 times for the niduses too big or too more. Conclusion The treatment of rotating γ-knife radiosurgery in intracranical benign tumors, malignant tumors, artereovenous malformation and functional diseases is effective. Thus it is an important therapentic approach in neurosurgery.
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