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首页> 外文期刊>Neurosurgery >Regional cerebral blood flow in peritumoral brain edema during dexamethasone treatment: a xenon-enhanced computed tomographic study.
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Regional cerebral blood flow in peritumoral brain edema during dexamethasone treatment: a xenon-enhanced computed tomographic study.

机译：地塞米松治疗期间肿瘤周围脑水肿中的局部脑血流量：氙气增强的计算机断层扫描研究。

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OBJECTIVE: Regional cerebral flood flow (rCBF) in peritumoral brain edema is assumed to be decreased because of increased interstitial pressure. Impaired blood flow might lead to local hypoxia, altered metabolism, and disturbed ion homeostasis, thus causing neurological sequelae. Steroid treatment is thought to positively influence the sequelae of brain edema. We aimed to determine the rCBF in peritumoral edema in humans receiving dexamethasone treatment and the relationship of rCBF to global CBF. METHODS: We measured rCBF in 11 patients with untreated anaplastic gliomas or glioblastomas that were World Health Organization Grade III or IV restricted to one hemisphere with significant peritumoral edema who were receiving a standard dose of dexamethasone. rCBF was determined using stable xenon-enhanced computed tomography in a stereotactic frame. Edema was defined both by means of actual histology (stereotactic biopsies) and by imaging criteria. RESULTS: rCBF in peritumoral edema was decreased by 32% as compared with contralateral normal white matter. In each patient, this reduction was linearly related to blood flow in nonaffected white matter and cortex. The flow ratio in the different compartments was 1 (edema):1.5 (contralateral white matter):2.7 (contralateral cortex). Absolute perfusion values in contralateral cortex (means +/- standard deviations) (29.9+/-7.1 ml/100 g/min) and contralateral white matter (16.1+/-3.7 ml/100 g/min) were significantly decreased as well. CONCLUSION: Our study demonstrated that rCBF in peritumoral brain edema during steroid treatment is still decreased and is in a range in which it may cause neurological sequelae. Also, global CBF was decreased in all patients.
机译：目的：由于间质压升高，肿瘤周围脑水肿的局部脑洪水流量（rCBF）被认为减少。血流受损可能导致局部缺氧，代谢改变和离子稳态失调，从而引起神经系统后遗症。类固醇治疗被认为对脑水肿的后遗症有积极影响。我们旨在确定接受地塞米松治疗的人肿瘤周围水肿中的rCBF以及rCBF与整体CBF的关系。方法：我们测量了11例未经治疗的间变性神经胶质瘤或胶质母细胞瘤的rCBF，这些患者接受标准剂量的地塞米松治疗，这些患者是世界卫生组织III级或IV级局限于一个明显的瘤周水肿的半球。使用立体定位框架中稳定的氙气增强计算机体层摄影术确定rCBF。通过实际的组织学（立体定向活检）和影像学标准定义水肿。结果：与对侧正常白质相比，肿瘤周围水肿中的rCBF降低了32％。在每位患者中，这种减少与未受影响的白质和皮质中的血流呈线性关系。不同隔室中的流量比为1（水肿）：1.5（对侧白质）：2.7（对侧皮层）。对侧皮质的绝对灌注值（平均值+/-标准偏差）（29.9 +/- 7.1 ml / 100 g / min）和对侧白质（16.1 +/- 3.7 ml / 100 g / min）也显着降低。结论：我们的研究表明，类固醇治疗期间瘤周围脑水肿中的rCBF仍然降低，并且处于一定范围内，可能引起神经后遗症。此外，所有患者的总脑血流量均降低。

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