磁共振在诊断三叉神经痛及面肌痉挛中成像序列的选择  

Selection of MR imaging sequences in diagnosis of trigeminal neuralgia and hemifacial spasm

作　　者：王晓辉[1] 刘丹[1] 李军[1] 张贝[1] 赵荣娟[1] 孙旗[1] 

机构地区：[1]解放军153医院放射科磁共振室,郑州450042

出　　处：《医疗卫生装备》2014年第7期77-79,共3页Chinese Medical Equipment Journal

摘　　要：目的:对磁共振应用常规及特殊成像序列诊断三叉神经痛(TN)及面肌痉挛(FS)的价值进行评价。方法:TN及FS患者52例,行SE T1WI、T2WI扫描,排除占位后再行3D-TSE序列和3D-VIBE序列扫描。经3D MRP、MIP、minMIP后处理图像,观察神经与周围血管的关系。结果:16例TN和8例FS为肿瘤引起,行切除术;23例TN和5例FS为血管压迫所致,行微血管减压术。3D-VIBE、3D-TSE序列综合判断血管压迫性三叉神经痛及面肌痉挛的阳性预测值、阴性预测值、敏感性、手术符合率分别为92%(23/25)、33.3%(1/3)、96%(24/25)、85.7%(24/28)。结论:磁共振扫描对明确三叉神经痛及面肌痉挛的病因具有重要价值,3D-TSE序列和3D-VIBE序列是显示血管神经空间关系的敏感方法,对TN和FS的术前评估具有较高的价值。Objective To evaluate the clinical significance of preoperative MRI in diagnosing trigeminal neuralgia （TN） and hemifacial spasm （HFS）. Methods Totally 52 patients with TN or FS underwent SE T1WI and T2WI scanning, and then scanning of 3D-TSE sequence and 3D-VIBE sequence after space occupying excluded. 3D MRP, MIP and min-MIP were used for the post-procession of the images in order to make clear the relationship between the nerve and the surrounding vessels. Results In the patients, 16 TN ones and 8 FS ones resulted from tumors and went through resection, and 23 TN ones and 5 FS ones were caused by vascular compression and went through microvascular decompression. 3D- VIBE and 3D-TSE sequences proved that the values for the positive prediction, negative prediction, sensitivity, coincidence rate were 92% （24/25）, 33.3% （1/3）, 96% （24/25） and 85.7% （24/28） respectively. Conclusion MR scanning is valuable for diagnosing the causes of TN and HFS. 3D-VIBE and 3D-TSE sequences are sensible for displaying the relationship between the nerve and vessel, and thus is significant for the preoperative evaluation of TN and FS. [Chinese Medicat Equipment Journal, 2014,35 （7） ： 77-79]

关 键 词：磁共振成像 三叉神经痛 面肌痉挛 血管压迫 

分 类 号：R445.2[医药卫生—影像医学与核医学] R745.1[医药卫生—诊断学]