磁共振3D TOF联合3D CISS对面肌痉挛病人的术前评估价值  

Preoperative evaluation value of MRI 3D TOF combined with 3D CISS for patients with hemifacial spasm

作　　者：霍文君[1] 郭辉[1] 崔斌[2] 林贵军[1] 

机构地区：[1]北京大学航天临床医学院神经外科,100049 [2]北京大学航天临床医学院影像科,100049

出　　处：《中国微侵袭神经外科杂志》2014年第6期245-248,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨MRI三维时间飞跃法血管成像序列(3D TOF)联合三维稳态构成干预序列(3D CISS)术前对面肌痉挛病人面神经与邻近血管关系的评估价值。方法回顾性分析95例行微血管减压术的面肌痉挛病人的临床资料,术前行3D TOF和3D CISS两种序列扫描并分析面神经与邻近血管关系,然后与术中实际观察结果进行对比。结果术中发现:面神经出脑干区(root exit zoom,REZ)存在动脉压迫或接触94例,面神经外周段受压1例。术前3D TOF联合3D CISS序列检查发现面神经REZ存在动脉压迫或接触94例,未发现责任血管1例,与手术所见完全符合。单纯3D TOF和3D CISS发现面神经REZ存在血管压迫或接触分别为88例和81例。3D TOF联合3D CISS检查阳性率与单独应用这两种检查差异均存在统计学意义(均P<0.05)。结论 3D TOF联合3D CISS序列对于显示面神经和邻近血管的关系可以很好地进行互补,提高检查阳性率,对术前诊断及手术方案有重要意义。Objective To investigate the value of MRI three-dimensional time of flight angiographic sequence （3D TOF） combined with three-dimensional constructive interference in steady state sequence （3D CISS） in evaluating the relationship between the facial nerve and adjacent vessels in patients with hemifacial spasm （HFS） before operation. Methods Clinical data of 95 patients with HFS who underwent microvascular decompression were analyzed retrospectively. All the patients were examined by 3D TOF and 3D CISS, and the relationship between the facial nerve and adjacent vessels were analyzed. Then the MRI results were compared with the intraoperative observation. Results The arterial compression or contact on the facial nerve root exit zoom （REZ） was found in 94 patients and the vascular compression in distal portion of the facial nerve was found in 1 patient during operation. The preoperative 3D TOF combined with 3D CISS results showed that arterial compression or contact on the facial nerve REZ was found in 94 patients and the relevant vessels was not found in 1 patient, which was coincident with observation of operation. The arterial compression or contact on the facial nerve REZ was found in 88 patients by using simple 3D TOF and 81 by using simple 3D CISS. The difference in positivity rate between 3D TOF combined with 3D CISS and 3D TOF or 3D CISS was statistically significant （both P 〈 0.05）. Conclusions 3D TOF and 3D CISS can complement each other well in displaying the relationship between the facial nerve and adjacent vessels in order to improve the positivity rate, which is significant for preoperative diagnosis and surgical planning.

关 键 词：面肌痉挛 磁共振成像 微血管减压术 

分 类 号：R745.12[医药卫生—神经病学与精神病学]