目的研究分析肺癌脑转移立体 定向放疗(stereotactic radiotherapy， SRT)后患者MRI变化情况及对近期疗效的 评价情况。方法 选择2010年1月至2013年 12月在我院接受治疗的肺癌脑转移患者 62例作为研究对象。所有患者均接受SRT 治疗后，分析患者近期疗效及MRI变化情 况，对比复发和可疑进展的时间情况。 结果 62例患者的120个病灶中，治疗后 CR的病灶占比为25.00%，PR的病灶占比 为15.00%，CR+PR有效率为40.00%。120个 病灶中，经SRT治疗后复发28个，其中26 个病灶挽救治疗后的体积增大，12个为结 节状强化，14个为不均匀强化。可疑进展 22个。病灶控制70个，其中12个体积较治 疗前略微变大的病灶中，10个为光滑亦或 是花环状的强化病灶，2个为不均匀强化 并且没有明显瘤周水肿和占位效应的病 灶。复发病灶的中位时间显著少于可疑 进展的中位时间，差异有统计学意义（P ＜0.05）。结论 肺癌脑转移患者接受SRT 治疗后的影像学表现较为多样，对于厚壁 和结节样，以及不均匀强化等情况应在对 症治疗、临床观察及其他类检查工具配合 诊断的基础上确定SRT治疗效果。

Objective To study evaluation analysis of lung cancer with brain metastasis patients after stereotactic radiotherapy MRI change condition and for short-term effect. Methods 62 cases of patients were chosen as the research object from January 2010 to December 2013 in our hospital to accept the treatment of brain metastases of lung cancer. All patients were given with SRT, after treatment analysis of patients with recent curative effect and changes of MRI, time and suspicious recurrence progress of contrast. Results 62 cases of patients with 120 lesions, after treatment of CR lesions accounted for 25%, PR lesions accounted for 15%, CR+PR efficiency was 40%. 120 lesions, after the treatment of SRT recurrence in 28, of which 26 lesions after salvage treatment volume increased, 12 was as nodular enhancement, 14 was heterogeneous enhancement. Suspicious progress was 22. Focus control 70, of which 12 volume than before treatment slightly larger lesions, 10 smooth or flower ring enhancing lesions, 2 heterogeneous enhancement and no obvious peritumoral edema and mass effect of the lesions. The median time to relapse at a median time of lesions was significantly less suspicious progression; the difference was statistically significant (P<0.05). Conclusion The patients of brain metastases from lung cancer treated with SRT imaging findings are various, for thick wall and nodular, and inhomogeneous enhancement etc. shall determine the therapy effect of SRT therapy, the clinical observation in symptomatic and basis for other classes with the diagnosis of inspection tools.