Gröger U, Huber P, Reulen H J
Department of Neurosurgery, University of Berne, Switzerland.
Acta Neurochir Suppl (Wien). 1994;60:373-4. doi: 10.1007/978-3-7091-9334-1_100.
In 16 patients with 21 metastatic brain tumors and 9 patients with a malignant glioma, tumor volume, volume of the edematous tissue, edema production, speed of edema propagation and edema resolution were examined by using the CT. Edema production was determined according to a technique described previously and ranged between 0.09 and 1.63 ml/h in metastases and between 0.42 and 3.49 ml/h in gliomas. The speed of edema propagation ranged from 0.2-2.2 mm/h. Edema resolution can take place within the tissue (i.e. reabsorption into blood) as well by drainage into the ventricular or subarachnoid CSF. In a few small metastases with a small perifocal edema (without contact to the ventricule or the subarachnoid space) the amount of edema resolution within the tissue could be determined and averaged 0.0086 ml/h/cm3. This probably represents the reabsorption of edema fluid into capillaries within the edematous tissue. If this value is used to calculate the edema reabsorption in larger tumors, the resulting data are considerable lower than the respective edema production rate of that tumor. This indicates, that in larger tumors the main fraction of the edema fluid is draining into the ventricular and/or subarachnoid CSF.
对16例患有21个脑转移瘤的患者和9例恶性胶质瘤患者,采用CT检查肿瘤体积、水肿组织体积、水肿产生情况、水肿扩散速度和水肿消退情况。水肿产生情况根据先前描述的技术确定,转移瘤的水肿产生速度在0.09至1.63毫升/小时之间,胶质瘤的水肿产生速度在0.42至3.49毫升/小时之间。水肿扩散速度为0.2 - 2.2毫米/小时。水肿消退可在组织内发生(即重新吸收进入血液),也可通过引流至脑室或蛛网膜下腔脑脊液实现。在少数周围水肿较小(未与脑室或蛛网膜下腔接触)的小转移瘤中,可确定组织内的水肿消退量,平均为0.0086毫升/小时/立方厘米。这可能代表水肿液重新吸收进入水肿组织内的毛细血管。如果用这个值来计算较大肿瘤中的水肿再吸收情况,所得数据远低于该肿瘤各自的水肿产生率。这表明,在较大肿瘤中,大部分水肿液引流至脑室和/或蛛网膜下腔脑脊液中。