面神经脑池段与其周围血管的MRI重建观测及临床应用  

MRI reconstruction observation and clinical application of the cisternal segment of facial nerve with its surrounding vessels

作　　者：苗莹莹 吕方[2] 侯明月 赵俊强 付升旗[3] MTAO Ying-ying;LV Fang;HOU Ming-yueJ;ZHAO Jun-qiang;FU Sheng-qi(Department of Anatomy, Sanquan College of Xinxiang Medical University;Department of MRI, Third Affiliated Hospital of Xinxiang Medical University;Department of Anatomy, Xinxiang Medical University, Xinxiang 453003, China)

机构地区：[1]新乡医学院三全学院人体解剖学教研室,新乡453003 [2]新乡医学院第三附属医院MRI室,新乡453003 [3]新乡医学院解剖学教研室,新乡453003

出　　处：《中国临床解剖学杂志》2018年第1期17-21,共5页Chinese Journal of Clinical Anatomy

基　　金：河南省软科学研究计划(174200410495)

摘　　要：目的为面神经脑池段与其周围血管是否存在压迫或接触提供形态学诊断依据。方法选取采用MRI 3D-FIESTA和3D-TOF序列扫描的检查正常者140例和单侧面肌痉挛患者70例,在MPR重建影像上观测I-CSFN-SV的血管直径、与脑干距离和血管自身角度、夹角及其与面肌痉挛发病率之间的关系。结果正常组、面肌痉挛健侧组和面肌痉挛患侧组I-CSFN-SV的血管直径、与脑干距离、血管自身角度、夹角分别为（0.48±0.03）mm、（0.49±0.04）mm、（0.71±0.06）mm和（8.69±0.62）mm、（8.66±0.75）mm、（5.93±0.47）mm,（74.39±2.33）°、（72.66±2.54）°、（48.57±3.28）°和（85.60±3.07）°、（86.75±2.73）°、（88.41±3.76）°,面肌痉挛患侧组与正常组、面肌痉挛健侧组I-CSFN-SV的血管直径、与脑干距离、血管自身角度均有显著性差异（P〈0.05）,夹角无显著性差异（P〉0.05）,且随着I-CSFN-SV与脑干距离的增加则发病率呈下降趋势,血管直径的增加和血管自身角度的减小则发病率呈上升趋势,夹角变化与发病率之间无显著性变化趋势。结论 I-CSFN-SV的血管直径、与脑干距离和血管自身角度是诊断是否存在压迫或接触的重要诊断指标,血管自身角度越小、血管直径越粗和相交处与脑干距离越近,则越容易出现面肌痉挛病变。Objective To provide evidence for the morphological diagnosis on the oppression and contact of the cisternal segment of facial nerve with its surrounding vessels. Methods 140 normal and 70 patients with unilateral hemifacial spasm were selected by MRI 3 D-FIESTA and 3 D-TOF sequence scanning.The following parameters were observed in the MPR reconstruction image, including the vascular diameter,distance to brainstem vascular self angle and included angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels, and its relationship with the morbidity of hemifacial spasm.Results The vascular diameter, distance to brainstem, vascular self angle and included angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels were（0.48±0.03）mm,（0.49±0.04）mm,（0.71±0.06） mm and（8.69±0.62） mm,（8.66±0.75）mm,（5.93±0.47） mm and（74.39±2.33） °,（72.66±2.54） °,（48.57 ± 3.28） ° and（85.60 ± 3.07） °,（86.75 ± 2.73） °,（88.41 ± 3.76） ° on the normal group, uninjured group of hemifacial spasm, ipsilateral group of hemifacial spasm,respectively. There were significant difference between the ipsilateral group of hemifacial spasm to the normal group, uninjured group of hemifacial spasm at the vascular diameter, to brainstem distance and vascular self angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels（P〈0.05）, there was no significant difference at the included angle（P〉0.05）. The morbidity decreased with the increase of intersection to brainstem distance,increased with the enlargement of vascular diameter and the reduction of vascular self angle. There was no significant change between the included angle to morbidity. Conclusions The vascular diameter, distance to brainstem and vascular self angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels are important diagnostic markers whether the oppression or contact exists

关 键 词：面神经 脑血管 MRI 多平面重组 面肌痉挛 

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]