3T核磁共振三维时间飞越法血管成像序列和三维循环相位稳态采集快速成像序列在原发性三叉神经痛术前评估中的应用  

Preoperative evaluation of trigeminal neuralgia using 3T three -dimensional time -of- flight mag- netic resonance angiography and three - dimensional fast imaging employing steady - state acquisi- tion

作　　者：刘佳[1] 陈谦学[1] 陈治标[1] 刘仁忠[1] 王峻[1] 邵灵敏[1] 秦兴平[1] 连海伟[1] 

机构地区：[1]武汉大学人民医院神经外科,430060

出　　处：《中华实验外科杂志》2016年第2期502-504,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨3T核磁共振三维时间飞越法血管成像序列（3D-TOF—MRA）和三维循环相位稳态采集快速成像序列（3D—FIESTA）在原发性三叉神经痛术前评估中的应用。方法分析52例原发性三叉神经痛患者术前3T核磁共振3D—TOF—MRA＋3D—FIESTA序列的影像资料，比较症状侧和无症状侧血管与三叉神经的关系，并将术前核磁共振结果与术中所见进行对比，分析影像学诊断的灵敏度和特异度。术后随访患者2年，观察疼痛缓解情况，分析术前核磁共振结果与患者手术预后的关系。结果术前3T核磁共振3D．TOF—MRA＋3D．FIESTA显示症状侧血管神经间存在接触或压迫关系的阳性率为90．4％，而无症状侧仅为25．0％；术前核磁共振影像诊断责任血管的灵敏度为89．8％，特异度为100．0％，影像学结果与术中所见一致性良好；术后随访提示阳性患者较阴性患者的手术预后明显更好。结论联合应用3T核磁共振3D—TOF—MRA＋3D．FIESTA扫描在原发性三叉神经痛术前诊断责任血管的灵敏度和特异度高，能协助临床医师进行术前诊断和评估，并预测患者手术预后。Objective To explore the preoperative evaluation of primary trigeminal neuralgia （TN） using 3T three- dimensional time- of- flight magnetic resonance angiography （3D -TOF- MRA ） and three- dimensional fast imaging employing steady- state acquisition （3D- FIESTA）. Methods 3D - TOF - MRA and 3D - FIESTA were performed on 52 patients with primary TN in our study. The rela- tionship between vessels and trigeminal was compared on the symptomatic side and the asymptomatic side. The preoperative magnetic resonance imaging （MRI） findings and the surgical findings were compared. The sensitivity and specificity of preoperative MRI diagnosis were caculated. A 2 - year follow - up was carried out after surgery and the relationship of preoperative MRI findings and clinical outcome was ana- lyzed. Results The preoperative 3T Mill showed that the positive rate on the symptomatic side was 90. 4%, and that on the asymptomatic side was just 25.0%. The sensitivity of preoperative MRI diagnosis was 89. 8% and the specificity was 100.0%. The preoperative MRI findings were in good accordance with the surgical findings. The patients with MRI positive findings had better outcome than the patients with MRI negative findings. Conclusion Preoperative 3T MRI combined with 3D - TOF - MRA and 3D- FIESTA has good sensitivity, specificity and predictive value in primary TN patients who are candi- dates for microvascular decompression.

关 键 词：三维时间飞越法血管成像序列 三维循环相位稳态采集快速成像序列 原发性三叉神经痛 术前评估 

分 类 号：R745.11[医药卫生—神经病学与精神病学]