3D-TOF-SPGR磁共振血管成像在三叉神经痛神经血管压迫诊断中的价值  

Diagnostic Value in Detecting the Neurovascular Compression with 3D-TOF-SPGR MR Angiography in Trigeminal Neuralgia

作　　者：任大卫[1] 朱勇猛[1] 黄国平[1] 孔嘉玲[1] 

机构地区：[1]宁波市第一医院影像科,浙江宁波315010

出　　处：《实用放射学杂志》2010年第11期1568-1570,共3页Journal of Practical Radiology

摘　　要：目的 探讨3D-TOF-SPGR磁共振血管成像（MRA）在三叉神经痛（TN）神经血管压迫临床诊断中的应用价值.方法 三叉神经痛患侧组23例（23侧神经）、正常对照组31例（39侧神经）,利用SE-T1WI、FSE-T2WI、MR三维时间飞跃稳态梯度回波序列（3D-TOF-SPGR）MRA图像及MPR斜矢状位、冠状位重组图像,盲法观察3个方位图像,以判定三叉神经与局部微小血管的关系.结果 三叉神经痛患侧组23侧神经,19侧表现为神经血管压迫阳性,占82.6%;正常对照组39侧神经,11侧表现为阳性,占28.2%,TN患者组与正常对照组χ2=17.15,P＜0.005,具有统计学差异.在MRA图像中,TN患者组阳性者微小血管与三叉神经的关系密切,有13侧表现为受压三叉神经不同程度弯曲、变形;正常对照组阳性者微小血管与三叉神经仅表现为横过、平行或密贴,相应三叉神经形态及信号均无明显异常表现.结论 3D-TOF-SPGR序列MRA对神经血管压迫三叉神经痛具有很高的临床诊断价值,并可为微血管减压术提供术前指导.Objective To explore applied value of 3D--TOF--SPGR magnetic resonance angiography （MRA） in diagnosis of neurovascular compression in trigeminal neuralgia（TN）. Methods 23 patients （23 sides） with trigeminal neuralgia and 31 healthy subjects （39 sides） were scanned with MR imaging, including SE-T1 WI, FSE-- T2 WI, MR three-- dimensional time-- of-- flight spio- sed gradient echo sequence （3D--TOF--SPGR）, MRA and MPR oblique--sagittal, coronal, re--images and blinded observation of three orientation images to determine the relationship between trigeminal nerves and tiny blood vessels. Results 19 sides in 23 cases with trigeminai neuralgia and 11 sides in 31 control subjects showed positive neurovascular compression about 82.6% and 28.2% respectively, there was statistically significant difference between TN group and control group（x^2= 17.15, P〈0. 005）. In TN--positive patient groups, MRA showed the tiny blood vessels were closed to the trigeminal nerve, 13 sides of trigeminal nerve showed bend and deformation. The small blood vessels and trigeminal nerve in positive control group showed only a cross, parallel or dense paste. Conclusion 3D--TOF--SPGR sequence MRA is of important value in diagnosing trigeminal neuralgia by neurovascular compression and available for microvascular decompression preoperative guidance.

关 键 词：脑 三叉神经痛 磁共振成像 

分 类 号：R745.11[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]