Clinical outcomes of gamma knife radiosurgery in the treatment of patients with trigeminal neuralgia.
ABSTRACT Since its introduction by Leksell, Gamma Knife radiosurgery (GKRS) has become increasingly popular as a management approach for patients diagnosed with trigeminal neuralgia (TN). For this reason, we performed a modern review of the literature analyzing the efficacy of GKRS in the treatment of patients who suffer from TN. For patients with medically refractory forms of the condition, GKRS has proven to be an effective initial and repeat treatment option. Cumulative research suggests that patients treated a single time with GKRS exhibit similar levels of facial pain control when compared to patients treated multiple times with GKRS. However, patients treated on multiple occasions with GKRS are more likely to experience facial numbness and other facial sensory changes when compared to patients treated once with GKRS. Although numerous articles have reported MVD to be superior to GKRS in achieving facial pain relief, the findings of these comparison studies are weakened by the vast differences in patient age and comorbidities between the two studied groups and cannot be considered conclusive. Questions remain regarding optimal GKRS dosing and targeting strategies, which warrants further investigation into this controversial matter.
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ABSTRACT: To explore whether strain ratio measurement could semi-quantitatively evaluate the stiffness of breast lesions. From January 2008 to May 2008, 148 patients with 254 solid lesions (183 benign, 71 malignant) in the breast were included in the study. Ultrasound sonography found the lesions and ultrasonic elastography obtained the strain images. By using the strain ratio measurement method together with the ultrasound machine, the strain index of the lesion was calculated. Different depths of breast tissue were selected as the reference. The strain indexes of malignant and benign solid lesions were calculated with the same level of breast tissue as the reference. The strain indexes of breast lesions were different compared to the same depth of breast tissue and the superior level of fat tissue (P = 0.000). The strain indexes of breast lesions were different compared to different depths of breast glandular tissues (P = 0.003). At the same level of the breast lesions, 212 lesions were glandular tissue, 11 were fat tissue, and 40 were both. In the lesion plane, six lesions had almost no glandular tissue and 20 had almost no superior fat tissue. Compared to the same depth of breast tissue, the strain indexes of benign lesions (range, 0.62-11.07) and malignant lesions (range, 3.12-39.28) were different (P = 0.000). Using the strain ratio measurement, stiffness of breast lesions could be semi-quantitated with the same depth of breast tissue as the reference. This method may provide another diagnostic method in addition to the 5-point scoring system used with ultrasonic elastography in the future.Academic radiology 12/2008; 15(11):1347-53. · 2.09 Impact Factor