基于线性加速器的立体放射性手术 (SRS) 动脉静脉形 (AVM) 用功能磁共振成像 (fMRI) 脑图绘制以避免有毒物质
Jafri M Abdullah1, Gokula Kumar Appalanaido2,3, Nur Asma Sapiai4
1Brain Behaviour Cluster and Department of Neurosciences, Universiti Sains Malaysia Health Campus/School of Medical Sciences, Universiti Sains Malaysia Health Campus, Kubang Kerian, MYS.
Cureus
|July 14, 2025
概括
立体辐射手术 (SRS) 有效地治疗了军用狙击手的脑动脉静脉形 (bAVM). 这种先进的技术最大限度地降低了毒性,并使患者能够保持健康.
科学领域:
- 神经外科 神经外科
- 辐射瘤学 辐射瘤学
- 医疗成像医学成像
背景情况:
- 大脑动脉静脉形形 (bAVMs) 存在复杂的治疗挑战,特别是当它们位于关键大脑结构附近时.
- 立体射线手术 (SRS) 是bAVM的关键干预措施,用于那些不适合进行手术或栓塞的患者.
- 基于线性加速器的骨SRS为精确的bAVM治疗提供了先进的功能.
研究的目的:
- 描述使用基于线性加速器的骨SRS用于Spetzler-Martin 3级bAVM的多学科方法.
- 报告用这种先进的SRS技术治疗的军事狙击手的结果和毒性.
主要方法:
- 功能性MRI (fMRI) 用于精确地绘制关键大脑区域.
- 用无框架立体影像面具进行CT模拟,并进行CT血管造影.
- 在SRS规划中,使用了Eclipse治疗规划系统 (TPS),对关键结构设置了特定的剂量限制.
主要成果:
- 在32个月后,左侧高壁面bAVM的3.2厘米x3.5厘米x3.7厘米完全消失.
- 患者没有经历与治疗相关的显著毒性.
- 患者成功地恢复了作为陆军狙击手的角色.
结论:
- 基于线性加速器的骨SRS,由先进的TPS引导,使复杂的bAVMs能够进行符合辐射疗法.
- 多学科的方法对于优化治疗计划和最大限度地减少毒性至关重要.
- 这一案例证明了SRS对位于大脑雄辩区域附近的头顶bAVM的疗效和安全性.
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