单侧血管源性三叉神经痛的神经与血管关系MRI研究  

MRI study of the relationship between nerve and blood vessels in unilateral vasogenic trigeminal neuralgia

作　　者：谭建霞 李仕广 江林 刘衡 马学进 蔡清 蒋其俊 TAN Jianxia;LI Shiguang;JIANG Lin;LIU Heng;MA Xuejin;CAI Qing;JIANG Qijun(Department of Radiology,the Third Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Department of Radiology,the First Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China;Department of Neurosurgery,the Third Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China)

机构地区：[1]遵义医科大学第三附属医院放射科,贵州遵义563000 [2]遵义医科大学第一附属医院放射科,贵州遵义563000 [3]遵义医科大学第三附属医院神经外科,贵州遵义563000

出　　处：《实用放射学杂志》2019年第12期1893-1896,共4页Journal of Practical Radiology

基　　金：贵州省科学技术基金项目[黔科合J字(2015)2153号];省市科技合作专项资金项目[省市科合(2015)54号]。

摘　　要：目的探讨单侧血管源性三叉神经痛(VTN)患者的三叉神经与责任血管的关系,以提高本病的诊治水平。方法分析23例经微血管减压术证实单侧VTN患者患侧及健侧三叉神经与责任血管之间的关系,评价三叉神经与责任血管交集点的位置、方向和交集形式。结果23例患者中,患侧23例均存在责任血管,健侧13例存在责任血管。(1)三叉神经与责任血管的交集点位置:患侧位于三叉神经脑池段后2/5范围;健侧位于脑池段前3/5;患侧与健侧有显著差异。(2)交集点方向:患侧共21例(21/23,91%)责任血管位于三叉神经内上方,2例(2/23,9%)位于三叉神经外下方;健侧12例(12/13,92%)责任血管位于三叉神经内上方,1例(1/13,8%)责任血管位于三叉神经外下方;两侧无显著差异。(3)交集形式:患侧2例(2/23,9%)责任血管接触三叉神经,20例(20/23,87%)责任血管压迫三叉神经,1例(1/23,4%)责任血管致使三叉神经扭曲;健侧6例(6/13,46%)责任血管接触三叉神经,7例(7/13,54%)责任血管压迫三叉神经;两侧有显著差异。结论单侧VTN患者在患侧、健侧的三叉神经与责任血管的交集点位置、交集形式上有差异,可为VTN术前诊断及术中导航提供线索。Objective To analyze the relationship between the trigeminal nerve and the responsible vessel(RV)in patients with unilateral vasogenic trigeminal neuralgia(VTN),and to improve the diagnosis and treatment of this disease.Methods The relationship between trigeminal nerve and RV was analyzed in the affected and healthy sides of 23 patients with unilateral VTN confirmed by microvascular decompression,and the position,direction and intersection form of their intersection were evaluated.Results Among the 23 patients,there were 23 patients with RV in affected sides,and 13 patients in the healthy sides.(1)intersection position of trigeminal nerve and RV:the affected sides were located within the posterior two-fifths of the cistern segment of trigeminal nerve while the healthy sides were located within the other three-fifths.There were significant statistical differences between the location of affected sides and healthy sides.(2)direction of intersection:the RV of 21 cases(21/23,91%)was above the inner part of trigeminal nerve and that of 2 cases(2/23,9%)was below the outer part of trigeminal nerve in affected sides.The RV of 12 cases(12/13,92%)was above the inner part of trigeminal nerve and that of 1 case(1/13,8%)was below the outer part of trigeminal nerve in healthy side.There were no significant statistical differences between the two sides.(3)intersection form:there were 2 cases(2/23,9%)with contact between RV and trigeminal nerve,20 cases(20/23,87%)with compression and 1 case(1/23,4%)with distortion of RV caused by trigeminal nerve in affected sides;There were 6 cases(6/13,46%)with contact and 7 cases(7/13,54%)with compression between trigeminal nerve and RV in healthy sides.There were significant statistical differences between the two sides.Conclusion In patients with unilateral VTN,the position and form of intersection of trigeminal nerve and RV in affected sides were different from those in healthy sides,which can provide clues for preoperative diagnosis and intraoperative navigation of VTN.

关 键 词：三叉神经痛 血管神经压迫 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]