3D-TOF MRA联合双激发B-FFE对三叉神经血管压迫的诊断价值  

Value of 3D-TOF MRA combined with double activated B-FFE in the diagnosis of trigeminal neuralgia

作　　者：仲建全[1] 巫恒平 郭欢[1] 唐翎[1] 

机构地区：[1]自贡市第一人民医院放射科,四川自贡643000

出　　处：《海南医学》2017年第20期3349-3351,共3页Hainan Medical Journal

摘　　要：目的探讨3D-TOF MRA联合双激发B-FFE结合后处理技术对三叉神经血管压迫的诊断价值。方法回顾性分析自贡市第一人民医院2013年5月至2016年8月间经临床手术证实的26例原发性血管压迫性三叉神经痛患者的MRI图像,运用3D-TOF MRA联合双激发B-FFE序列扫描获得的原始图像并结合多平面重建(MPR)及多方位最大密度投影(MIP)分析责任血管与三叉神经的空间关系及责任血管起源,并与手术结果对照。结果26例原发性血管压迫性三叉神经痛患者中,MRI均能明确责任血管与三叉神经的关系,并与手术结果一致;责任血管分别为小脑上动脉(SCA)16例,小脑前下动脉(AICA)3例,小脑后下动脉(PICA)3例,岩静脉2例,桥脑横静脉1例,小脑上动脉及岩静脉同时压迫2例,椎动脉、小脑上动脉、小脑下前动脉、岩静脉共5组血管分支压迫1例;神经根进入区(REZ)是三叉神经最易受血管压迫的部位。结论 3D-TOF MRA联合双激发B-FFE序列扫描并结合图像后处理技术可清楚显示责任血管与神经的关系及责任血管起源,具有较高的临床价值。Objective To explore the value of three-dimensional time-of-flight （3D TOF） magnetic resonance angiography （MRA） combined with double activated balanced fast-field echo （B-FFE） in the diagnosis of trigeminal neuralgia （TN）. Methods The MRI images of 26 patients with primary vascular compression trigeminal neuralgia con-firmed by surgical results in Zigong First People＆#39;s Hospital from May 2013 to August 2016 were retrospectively ana-lyzed. Images obtained by 3D-TOF MRA combined with double activated B-FFE, multi-planner reformation （MPR）, and maximal density projection （MIP） were used to analyze the spatial relationship between offending vessels and trigeminal nerve and the origin of offending vessels, and compared with the results of surgery. Results In 26 cases of primary vas-cular compression of trigeminal neuralgia, MRI was able to clearly show the relationship between offending vessels and trigeminal nerve, and consistent with the surgical results;the offending vessels were respectively 16 cases of upper cere-bellar artery, 3 cases of anterior inferior cerebellar artery, 3 cases of posterior inferior cerebellar artery, 2 cases of petrosal vein, 1 case of transverse vena, 2 cases of upper cerebellar artery and petrosal vein, 1 case of vertebral artery, upper cere-bellar artery, anterior inferior cerebellar artery, petrosal vein. The nerve root entry area （REZ） was the most vulnerable part of the trigeminal nerve. Conclusion 3D-TOF MRA combined with double activated B-FFE sequence can clearly show the relationship between offending vessels and nerve and the origin of offending vessels, which has high clinical value.

关 键 词：三叉神经 磁共振成像 责任血管 血管压迫 

分 类 号：R745.11[医药卫生—神经病学与精神病学]