脑电图在非颅内肿瘤所致放射性脑病中临床应用.docVIP

脑电图在非颅内肿瘤所致放射性脑病中临床应用 　　[摘要]目的 探讨脑电图在非颅内肿瘤所致放射性脑病（REP）患者的临床应用价值。 方法 18例非颅内肿瘤患者接受放射线治疗后，进行脑电图、头颅MRI检查。采用回顾性分析，进行脑电图异常脑波出现范围及定位与头颅MRI放射性病灶范围及定位的比较，并根据MRI结果分为MRI阳性组和阴性组。 结果 18例放射性脑病患者中，9例头颅MRI阴性，9例头颅MRI阳性。两组患者的脑电图和头颅MRI检查比较，影像学阴性组患者脑电图异常脑波出现的平均导联数为11，异常脑波以θ波为主。影像学阳性组患者MRI病灶平均体积为35.2cm3，脑电图异常脑波以δ波为主，且无论MRI单侧病灶或双侧病灶，异常脑波的出现均为双侧，病灶侧为重；1例患者出现尖慢复合波。全部患者的异常脑波出现率为100%。上述数据表明，患者头颅MRI尚未发现明确放射性病灶时，脑电图即可检出慢波增多，程度多为轻度，少数为中-重度；患者头颅MRI已发现明确病灶时，仅有极少数患者脑电图为轻度异常，多数患者为中等程度至重度异常，而且常表现为异常脑电波全导联同步发放，出现异常脑电波的导联范围往往明显超出MRI病灶范围。证明脑电图异常改变的出现早于影像学异常。 结论 放射性脑病患者的脑电图异常改变的出现早于影像学异常改变，因此临床上应用脑电图检查，有早期预测价值，早期脑电图检查对放射性脑病患者的早诊断、早干预、早治疗提供重要的依据。 　　[关键词]放射性脑病；脑电图；头颅MRI；非颅内肿瘤；鼻咽癌放射性脑病 　　[中图分类号] R742 [文献标识码] B [文章编号] 2095-0616（2015）01-175-04 　　[Abstract] Objective To explore the clinical application of EEG in patients with radiation encephalopathy caused by non-intracranial tumors. Methods Retrospectively analyze 18 cases of non-intracranial tumor patients who received EEG and cranial MRI （magnetic resonance imaging） after radiation therapy for non-intracranial tumors， to analyze the positioning and scope of regions with abnormal EEG waves and the localization and scope of radiation lesions in cranial MRI. The patients were divided into MRI-negative and -positive groups according to the MRI results. Results Among the 18 cases of radiation encephalopathy patients， 9 cases were MRI-negative， and 9 were positive. Comparison of the results of EEG and cranial MRI between the 2 groups indicated that the average number of leads in EEG waves among MRI-negative patients was 11， and the abnormal EEG appeared as θ-wave-based. The average volume of MRI lesion in MRI-positive patients was 35.2cm3， and the abnormal EEG waves were δ-wave-based. Regardless of MRI unilateral or bilateral lesions， abnormal EEG waves appeared bilaterally， but severer in ipsilateral side. One patient showed sharp slow complex wave. The occurrence rate of abnormal EEG among all patients was 100%. The above data indicated that when cranial