三叉神经脑池段体积、冠状位截面积测量与原发性三叉神经痛中责任血管、神经压迫的关系研究  

Association of the measurement of cisternal volume and coronal sectional area of the trigeminal nerve with the compression of offending vessels and nerves in primary trigeminal neur-algia

作　　者：王克 代永庆 包志军 WANG Ke;DAI Yong-Qing;BAO Zhi-Jun(Department of Neurosurgery,3201 hospital,Hanzhong,Shanxi,723000)

机构地区：[1]三二〇一医院神经外科,陕西省汉中市723000

出　　处：《国际神经病学神经外科学杂志》2020年第1期22-26,共5页Journal of International Neurology and Neurosurgery

摘　　要：目的探讨原发性三叉神经痛(primary trigeminal neuralgia,PTN)患者责任血管的类型、血管压迫神经的部位、神经受压迫的程度与三叉神经体积之间的关系。方法采用回顾性研究,收集本院65例行MVD治疗PTN患者(病例组)的临床资料,同期选取35例于本院体检健康人员(对照组),对两组磁共振成像(MRI)影像上双侧三叉神经脑池段体积与冠状位截面积进行测量,并进行比较。比较不同责任血管类型、压迫神经部位和程度的患者双侧三叉神经脑池段体积差异、冠状位截面积差异。结果病例组症状侧三叉神经体积与冠状位截面积较非症状侧均明显减少(P<0.01),且较对照组亦明显减少(P<0.01);病例组非症状侧三叉神经体积、冠状位截面积与对照组比较,并无明显差异(P>0.05)。相比静脉压迫组,动脉压迫组双侧三叉神经脑池段体积差异、冠状位截面积差异明显升高(P<0.05)。不同压迫神经部位的患者,双侧三叉神经脑池段体积差异、冠状位截面积差异比较,存在明显差异(P<0.05)。相比Ⅰ级压迫组,Ⅱ~Ⅲ级压迫组双侧三叉神经脑池段体积差异、冠状位截面积差异明显升高(P<0.05);相比Ⅱ级压迫组,Ⅲ级压迫组双侧三叉神经脑池段体积差异、冠状位截面积差异明显升高(P<0.05)。结论三叉神经脑池段的萎缩与PTN的发病密切相关,并且不同责任血管类型、压迫神经部位和程度的患者三叉神经萎缩程度明显不同,提示脑池段三叉神经萎缩对PTN的诊断可能具有重要价值。Objective To investigate the type of offending vessels,the position of nerve compression by vessels,and the association between the degree of nerve compression and the volume of the trigeminal nerve in patients with primary trigeminal neuralgia(PTN).Methods A retrospective analysis was performed for the clinical data of 65 patients with PTN who underwent microvascular decompression(MVD)in our hospital(case group),and 35 healthy individuals who underwent physical examination in our hospital during the same period of time were enrolled as control group.Magnetic resonance imaging(MRI)was performed to measure the cisternal volume and the coronal sectional area of the bilateral trigeminal nerve,which was then compared between the two groups.The cisternal volume and the coronal sectional area of the bilateral trigeminal nerves were compared between the patients with different types of offending vessels or locations and degrees of nerve compression.Results For the case group,the volume and the coronal sectional area of the trigeminal nerve of the symptomatic side were significantly lower than those of the non-symptomatic side(P<0.01),and compared with the control group,the case group had significantly lower volume and coronal sectional area of the trigeminal nerve of the symptomatic side(P<0.01),while there were no significant differences in the volume and the coronal sectional area of the trigeminal nerve of the non-symptomatic side between the two groups(P>0.05).Compared with the venous compression group,the arterial compression group had significant increases in the cisternal volume and the coronal sectional area of the bilateral trigeminal nerves(P<0.05).There were significant differences in the cisternal volume and the coronal sectional area of the bilateral trigeminal nerves between the patients with different locations of nerve compression(P<0.05).Compared with the grade I compression group,the grade II-III groups had significant increases in the cisternal volume and the coronal sectional area of the bilateral tr

关 键 词：原发性三叉神经痛 三叉神经萎缩 责任血管 压迫神经 

分 类 号：R745.11[医药卫生—神经病学与精神病学]