三维双回波磁共振动静脉成像技术诊断血管压迫性三叉神经痛  

Three-dimensional dual echo MR angiography and venography in diagnosing vascular compressive trigeminal neuralgia

作　　者：戴艳芳[1,2] 陈楠[1,2] 李坤成[1,2] 

机构地区：[1]首都医科大学宣武医院放射科,北京100053 [2]磁共振成像脑信息学北京市重点实验室,北京100053

出　　处：《中国医学影像技术》2016年第11期1649-1653,共5页Chinese Journal of Medical Imaging Technology

基　　金：北京市医院管理局临床医学发展专项经费(ZYLX201609)

摘　　要：目的探讨三维双回波磁共振动静脉成像(3D双回波MRAV)对血管压迫性三叉神经痛的诊断价值。方法选取30例拟行三叉神经微血管减压术患者,术前行三维时间飞跃(3DTOF)序列和3D双回波MRAV序列成像,以手术结果为金标准,分析两种成像方法的图像质量和诊断动、静脉压迫三叉神经的一致性和效能。结果 3D双回波MRAV成像的SNR和CNR低于3DTOF法(t=4.50、7.43,P均<0.001)。3D双回波MRAV诊断压迫三叉神经的动脉、静脉责任血管的敏感度为97.22%(35/36),特异度为83.33%(20/24),准确率91.67%(55/60),与手术结果一致性较高(Kappa=0.82);3DTOF诊断动脉、静脉压迫三叉神经的敏感度、特异度分别为69.44%(25/36)、95.83%(23/24),准确率为80.00%(48/60),一致性低于3D双回波MRAV(Kappa=0.61)。结论 3D双回波MRAV序列可显示三叉神经根部与动、静脉位置关系,对血管压迫性三叉神经痛具有较高的诊断价值。Objective To evaluate the value of three-dimensional dual echo MR angiography and venography（3Ddual echo MRAV）sequence in diagnosing vascular compressive trigeminal neuralgia.Methods Thirty patients underwent trigeminal nerve decompression operation.3Dtime-of-flight（3DTOF）and 3Ddual echo MRAV scan were performed.And then the images quality and bilateral spatial relationship between trigeminal nerve and adjacent vessels were analyzed.The diagnostic results were compared with operative results.Results SNR and CNR of 3Ddual echo MRAV were lower than those of 3DTOF（t=4.50,7.43,both P〈0.001）.The sensitivity,specificity,accuracy of 3Ddual echo MRAV in diagnosing vascular compressive trigeminal neuralgia were 97.22%（35/36）,83.33%（20/24）,91.67%（55/60）,and had high consistency with operation（Kappa=0.82）,which of 3D TOF were 69.44%（35/36）,95.83%（23/24）,80.00%（48/60）,and the consistency was lower than that of 3Ddual echo MRAV（Kappa=0.61）.Conclusion 3Ddual echo MRAV can accurately determine whether the contact vessels existed on the trigeminal nerve,and it has a high diagnostic value in diagnosing vascular compressive trigeminal neuralgia.

关 键 词：三叉神经痛 双回波 时间飞跃 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]