原发性三叉神经痛术前MRI特征与微血管减压术后短期疗效的关系  

The Relationship between Preoperative MRI Characteristics and The Perioperative Outcomes of Microvascular Decompression in Primary Trigeminal Neuralgia

作　　者：唐四强[1] 漆松涛[1] 刘忆[1] 陈铭[1] 汪潮湖[1] 张喜安[1] 潘军[1] 石瑾[1] 黄广龙[1] 陈加贝[1] 

机构地区：[1]南方医科大学南方医院神经外科,广州510515

出　　处：《中国神经精神疾病杂志》2014年第8期459-463,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：国家重点临床专科专项资金;广东省科技计划项目(编号:2012B091100463)资助

摘　　要：目的探讨微血管减压术(microvascular decompression,MVD)治疗原发性三叉神经痛围手术期疗效与术前MRI相关因素的关系。方法分析我院经MVD治疗的103例三叉神经痛患者的术前MRI薄层增强扫描资料与围手术期疗效的关系。MRI相关因素包括:桥小脑角(cerebellopontine angle,CPA)面积比、三叉神经根(trigeminal nerve,TGN)截面积比、TGN长度比、压迫点距离和方位、基底动脉位置、责任血管类型;手术疗效分为:疼痛消失、缓解、无效。结果单因素统计分析显示:压迫方位(P=0.017)、压迫点距离(P<0.001)、责任血管类型(P=0.016)、TGN截面积比(P<0.001)是影响MVD围手术期疗效的因素。Logistic多因素回归分析显示:责任血管类型(P=0.002),TGN截面积比(P=0.020)是MVD围手术期疗效的预测因子。结论术前MRI显示责任血管是动脉、神经根无萎缩的患者MVD后围手术期疗效更好。Objective To evaluate the relationship between preoperative MRI characteristics and the perioperative outcomes of microvascular decompression in primary trigeminal neuralgia. Methods To analyze the relationship between preoperative MRI characteristics and the perioperative outcomes in 103 primary trigeminal neuralgia patients with micro-vascular decompression in Nanfang Hospital. The MRI features such as the ratio of CPA area, TGN cross-sectional area and TGN length was evaluated together with the TGN oppression distance, the position of TGN, the position of basilar ar-tery and the type of offending vessel as well as the outocmes including complete disappearance, temporary remission and ineffectiveness. Results Univariate analysis showed that the oppression orientation （P=0.017）, oppression distance （P〈0.001）, offending vascular type （P=0.016）, TGN cross-sectional area ratio （P〈0.001） were the influencing factors of periop-erative outcomes. Logistic regression analysis showed that the offending vascular type （P=0.002）and TGN cross-sectional area ratio （P=0.020） were the main predictive factors of perioperative outcomes of microvascular decompression. Conclu-sions Preoperative thin slice MRI scanning showed that the offending artery, non-atrophy nerve roots, far distance from op-pression point to brainstem may be the favorable factors of perioperative outcomes of microvascular decompression.

关 键 词：原发性三叉神经痛 MRI特征 短期疗效 神经根萎缩 桥小脑角面积 

分 类 号：R445.2[医药卫生—影像医学与核医学] R745.11[医药卫生—诊断学]