血管压迫性原发性三叉神经痛压迫位点与面部痛区关系的MRI研究  

Relationship between compression site of vascular compression of primary trigeminal neuralgia and facial pain area MRI study

作　　者：王清[1] 张振光[1] 李宗芳[1] 赵卫[1] 谢伟[1] 张荟美 WANG Qing;ZHANG Zhenguang;LI Zongfang;ZHAO Wei;XIE Wei;ZHANG Huimei(Department of Medical Imaging, the First Affiliated Hospital of Kunming Medical University, Kunming 650032, Chin)

机构地区：[1]昆明医科大学第一附属医院影像科,云南昆明650032

出　　处：《中国医学影像技术》2018年第4期499-503,共5页Chinese Journal of Medical Imaging Technology

基　　金：云南省应用基础研究(昆医联合专项)(2013FB130);云南省教育厅科学研究基金项目(2013Y280);昆明医科大学研究生创新基金(2016S82)

摘　　要：目的探讨MRI分析血管压迫性原发性三叉神经痛(PTN)患者神经血管压迫(NVC)位点空间方位与面部痛区关系的价值。方法回顾性分析123例单侧血管压迫性PTN患者三维时间飞跃法MRA(3DTOF MRA)、三维稳态进动快速成像、增强3DTOF MRA图像,依据三叉神经断面解剖特点将NVC位点空间方位划分为8个,结合神经断面长轴转位情况分析其中60例单支血管单点压迫PTN患者NVC位点空间方位与面部痛区的一致性;测量123例患者206个NVC位点到神经入脑干处距离(d)、神经根总长度(L),计算d/L比值。结果 60例单支血管单点压迫PTN患者中,57例(57/60,95.00%)NVC位点空间方位与面部痛区符合,3例(3/60,5.00%)不符合;其中d/L≤1/4的NVC位点占58.33%(35/60),d/L≤1/2的NVC位点占85.00%(51/60)。全部123例患者中,206个NVC位点平均d值为(2.50±1.35)mm,92个(92/206,44.66%)NVC位点d/L≤1/4,153个(153/206,74.27%)NVC位点d/L≤1/2。结论采用MRI判断血管压迫性PTN患者的NVC位点空间方位与面部痛区的关系并测量NVC位点距神经入脑干处的距离,有助于判定责任血管。Objective To investigate the value of MRI in analyzing relationship between compression site of the vascular compression and the facial pain area in patients with primary trigeminal neuralgia （PTN）. Methods MRI data of 123 patients with unilateral PTN were retrospectively analyzed, including imaging of three-dimensional-time of flight-MRA （3D TOF MRA） sequence, three-dimensional-fast imaging employing steady-state acquisition sequence and contrast-enhanced 3D TOF MRA sequence. Neurovascular conflict （NVC） sites were divided into 8 sites according to the sectional anatomy of trigeminal nerve, and the relations between topography of pain and site of NVC were analyzed in 60 PTN patients with a single offending vessel and a single site of NVC. Distance （d） from the root entry point to the site of NVC, the length （L） of cisternal segment of the trigeminal nerve were both measured, and d/L was calculated in 123 patients with 206 NVC points. Results Of 60 patients with single offending vessel and single site of NVC, 95.00% （57/60） sites of NVC matched to topography of pain, 5.00% （3/60） did not, whereas NVC points with d/L≤1/4 accounted for 58.33% （35/ 60）, d/L≤1/2 accounted for 85.00% （51/60）. Among 206 NVC points, the mean d was （2.50± 1.35）mm, and NVC points with d/L≤1/4 accounted for 44.66% （92/206）, d/L≤1/2 accounted for 74.27% （153/206）. Conclusion MRI is helpful to detecting the offending vessels in PTN patients through judging relationship between the topography of pain and the site of NVC, as well as measuring the distance from the root entry point to the site of NVC.

关 键 词：三叉神经痛 神经血管压迫 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]