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目的评估伽玛刀(γ?刀)治疗脑动静脉畸形(AVM)的疗效.方法用LEKSELγ?刀手术治疗脑AVM216例并随访12~34个月.患者年龄1?1~83岁,SPETZLERMARTIN分级:Ⅰ级42例,Ⅱ级68例,Ⅲ级95例,Ⅳ级7例,Ⅴ级4例.AVM体积0?3~43.9CM3,治疗用周边剂量12~30GY.结果γ?刀治疗后的AVM闭塞情况和并发症的发生与其体积、分级、定位方法、周边剂量、剂量规划及质量控制等因素有关.对体积≤5.0CM3或SPETZLERMARTIN分级＜Ⅲ级及周边剂量≥20GY者,其2年闭塞率超过78?5％.本组有4例γ?刀术后再出血,9例并发有明显症状的放射性脑水肿.结论γ?刀是治疗脑AVM的一种安全、有效的方法,特别是SPETZLERMARTINⅠ~Ⅱ级或体积≤5?0CM3的AVM及周边剂量≥20GY者疗效较好.数字减影血管造影(DSA)结合磁共振血管造影(MRA)联合定位对提高AVM的闭塞率、降低并发症有帮助“,”s Objective To evaluate the effects of gamma knife radiosurgery on brain arteriovenous malformations (AVM).Methods Two hundreds and sixteen patients with brain AVM treated by Leksell γ knife were followed up for 12 34 months. The patients were consisted of 162 male and 54 female, and the age ranged from 1.1 to 83 years. AVM volume ranged from 0.3 to 43.9 cm 3, peripheral doses of radiation ranged from 12 to 30 Gy. Spetzler Martin grading:grade Ⅰ 42 cases, grade Ⅱ 68 cases, grade Ⅲ 95 case...