Kural Cahit, Atac Gokce Kaan, Tehli Ozkan, Solmaz Ilker, Temiz Caglar, Hodaj Irgen, Izci Yusuf
Department of Neurosurgery, University of Health Sciences, Gulhane Education and Research Hospital, Ankara, Turkey.
Department of Radiology, Ufuk University, Ankara, Turkey.
Neurol Neurochir Pol. 2018 Aug;52(4):495-504. doi: 10.1016/j.pjnns.2018.03.002. Epub 2018 Mar 13.
To investigate the effects of dexamethasone on brain tumor and peritumoral edema by different sequences of magnetic resonance imaging (MRI).
MRI was performed in 28 patients with brain tumor. Patients were divided into the 3 groups based on the histological diagnosis; Group I: high-grade glial tumor, Group II: low-grade glial tumor, and Group III: brain metastasis. The measurements of peritumoral edema volume and apparent diffusion coefficient (ADC) values were performed while the peak areas of cerebral metabolites were measured by spectroscopy in groups I and II. The changes in edema volumes, ADC values and cholin/creatine peak areas were compared.
The volume of peritumoral edema was decreased in groups I and II, but increased in group III after dexamethasone treatment. These changes were not statistically significant for 3 groups. ADC value was decreased in group I and increased in groups II and III. Changes in ADC values were statistically significant. Cholin/creatine peak areas were decreased after dexamethasone in groups I and II, but these changes were also not significant.
Dexamethasone has no significant effect on the volume of peritumoral edema in glial tumor and metastasis. Moreover, dexamethasone increases the fluid movements in low grade gliomas and metastases, decreases in high grade gliomas. However, more comprehensive clinical studies are needed to show the effects of dexamethasone on brain tumors and peritumoral edema.
通过不同序列的磁共振成像(MRI)研究地塞米松对脑肿瘤及瘤周水肿的影响。
对28例脑肿瘤患者进行MRI检查。根据组织学诊断将患者分为3组;第一组:高级别胶质瘤,第二组:低级别胶质瘤,第三组:脑转移瘤。测量瘤周水肿体积和表观扩散系数(ADC)值,同时在第一组和第二组中通过磁共振波谱测量脑代谢物的峰值面积。比较水肿体积、ADC值和胆碱/肌酸峰值面积的变化。
地塞米松治疗后,第一组和第二组瘤周水肿体积减小,第三组增大。三组的这些变化无统计学意义。第一组ADC值降低,第二组和第三组升高。ADC值的变化具有统计学意义。地塞米松治疗后第一组和第二组胆碱/肌酸峰值面积降低,但这些变化也无统计学意义。
地塞米松对胶质瘤和转移瘤的瘤周水肿体积无显著影响。此外,地塞米松增加低级别胶质瘤和转移瘤中的液体流动,在高级别胶质瘤中则减少。然而,需要更全面的临床研究来显示地塞米松对脑肿瘤及瘤周水肿的影响。