3D-TOFMRA联合3D—FIESTA对三叉神经血管受压及脑池段形态学的初步研究  

Preliminary study of vascular compression and morphological characteristics of trigeminal nerve bridge forebay section by 3D-TOF MRA combined with 3D-FIESTA

作　　者：弥龙[1] 宋云龙[2] 陈红 李小华[1] 刘旭东[1] 施玉森[1] MI Long;SONG Yunlong;CHEN Hong;LI Xiaohua;LIU Xudong;SHI Yusen(Department of Radiology,the First Affiliated Hospital of Hainan Medical College,Haikou 570102,China;Department of Magnetic Resonance,Air Force General Hospital of People＇s Liberation Army,Beijing 100142,China)

机构地区：[1]海南医学院第一附属医院放射科,海南海口570102 [2]中国人民解放军空军总医院磁共振科,北京100142

出　　处：《实用放射学杂志》2018年第8期1160-1163,1171,共5页Journal of Practical Radiology

摘　　要：目的探讨三维时间飞跃法磁共振血管成像（3D-TOF MRA）联合三维稳态进动快速成像（3D-FIESTA）技术对三叉神经血管受压的诊断价值及对三又神经脑池段形态学定量评估的意义。方法回顾性分析本院临床诊断三又神经痛（TN）且MRI诊断三叉神经有血管受压的患者30例，扫描序列包括3D-TOFMRA序列、3D-FIESTA序列、轴位T1WI序列、轴位T2WI序列。所得图像导人工作站，进行三维重建，观察三叉神经与血管的空间关系，测量每个病例患侧与健侧三叉神经脑池段长度、三又神经脑桥角、三叉神经脑池段面积、桥小脑角池面积，并对4组数据进行对比分析。结果①3D-TOFMRA序列三叉神经为等信号，脑脊液表现为低信号，血流快的动脉为高信号；3D-FIETA序列三叉神经表现为束状低信号，血管表现为迂曲低信号，背景脑脊液表现为高信号。②本组30例三叉神经受压患者中，右侧血管受压13例，左侧17例。③患侧与健侧三叉神经脑池段长度无统计学差异，患侧与健侧三叉神经脑桥角、三叉神经脑池段面积、桥小脑角池面积有统计学差异，患侧小于健测。结论3D-TOF MRA及3D-FIESTA技术可清晰显示三叉神经的走行、有无增粗及其与周围血管的空间关系，对原发性TN的诊断有较大的价值。Objective To explore the diagnostic value of 3D-TOF MRA combined with 3D-FIESTA technique in the trigeminal nerve compressed by vascular,and the significance of 3D-FIESTA technique in the quantitative assessment of the morphology of trigeminal nerve bridge forebay section.Methods MR images of 30 patients, who clinically diagnosed of trigeminal neuralgia（TN） and combined with trigeminal nerve compressed by vessel on MRI in our hospital were analyzed retrospectively. Scanning sequence included 3D-TOF MRA, 3D-FIESTA, axial T1WI,axial T2WI.The images were imported into the workstation for 3D reconstruction, the spatial relationship between the trigeminal nerve and blood vessel was observed, and the length of the trigeminal nerve bridge forebay section,trigeminal nerve pontine angle, the area of the trigeminal nerve bridge forebay section,bridge cerebellopontine pool area of each case in diseased side and healthy side were measured and compared. Results ① The trigeminal nerve showed equal signal,cerebrospinal fluid showed low signal, vessels showed high signal on 3D-TOF MRA. The trigeminal nerve and vessels showed low signal, cerebrospinal fluid showed high signal on 3D-FIESTA sequence.② Among 30 cases of trigeminal vascular compression, 13 cases appeared on the right side and 17 cases on the left side.③ There was no significant difference in the length of trigeminal nerve bridge forebay section between the diseased side and healthy side.While the trigeminal nerve pontine angle,trigeminal nerve bridge forebay section area,bridge cerebellopontine pool area showed statistical difference, in which the affected side was less than that in the healthy side.Conclusion 3D TOF MRA and 3D-FIESTA technology can clearly show the shape of the trigeminal nerve and its spatial relationship with vascular. MRI has a greater diagnostic value for primary TN.

关 键 词：三叉神经 原发性三叉神经痛 三维时间飞跃法磁共振血管成像 三维稳态进动快速成像 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]