磁共振仿真内镜在三叉神经痛微血管减压术中的应用价值  

The evaluation of MR virtual endoscopy in microvascular decompression of primary trigeminal neuralgia

作　　者：沈健[1] 沈伟强[1] 苏忠周[2] 顾晓丽 SHEN Jian;SHEN Weiqiang;SU Zhongzhou;GU Xiaoli(Department of Radiology, Huzhou Centre Hospital (Zhejiang University Huzhou Hospital), Huzhou 313000, P.R.China;Department of Neurosurgery, Huzhou Centre Hospital (Zhejiang University Huzhou Hospital), Huzhou 313000, P.R.China;Department of Radiology, Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 200052, P.R.China)

机构地区：[1]浙江省湖州市中心医院,浙江大学湖州医院放射科,浙江湖州313000 [2]浙江省湖州市中心医院,浙江大学湖州医院神经外科,浙江湖州313000 [3]上海中医药大学附属光华医院放射科,上海200052

出　　处：《医学影像学杂志》2020年第7期1141-1144,共4页Journal of Medical Imaging

基　　金：浙江省湖州市科技计划项目(编号:2018GYB56)。

摘　　要：目的探讨基于3D-FIESTA的磁共振仿真内镜技术在三叉神经痛微血管减压术中的应用价值。方法回顾性分析2011年7月~2018年12月间98例单侧原发性三叉神经痛患者的临床及影像学资料,所有患者均经神经外科微血管减压术治疗确诊。将术前常规的3D-FIESTA和3D-TOF诊断结果作为常规组,将MRVE、3D-FIESTA、3D-TOF三者联合诊断结果作为联合组。结果联合组MRVE、3D-FIESTA、3D-TOF三者联合诊断血管接触的灵敏度、特异度和准确率分别为97.9%、100%及98.0%,灵敏度和准确率要优于常规组的3D-FIESTA和3D-TOF序列诊断,差异有统计学意义。98例患者术后随访6个月~2年,治愈率86.7%,显效率8.2%,有效率3.1%,无效率2.0%。结论磁共振仿真内镜技术可以清楚显示三叉神经和责任血管之间的三维空间关系,联合3D-FIESTA和3D-TOF序列后可以显著提高责任血管判断的灵敏度和准确率,对小动脉和静脉的检出更具优势,是原发性三叉神经痛术前评估的重要方法。Objective To explore the application value of MR virtual endoscopy in microvascular decompression of trigeminal neuralgia.Methods The clinical and imaging data of 98 patients with unilateral primary trigeminal neuralgia from July 2011 to December 2018 were analyzed retrospectively.All patients were confirmed by microvascular decompression in neurosurgery.The diagnostic results of 3D-FIESTA and 3D-TOF before operation were taken as the routine group,and the combined diagnostic results of MRVE,3D-FIESTA and 3D-TOF were taken as the combined group.Results The sensitivity,specificity and accuracy of MRVE,3D-FIESTA and 3D-TOF in the combined group were 97.9%,100%and 98.0%,respectively.The sensitivity and accuracy were better than those of the routine group in the 3D-FIESTA and 3D-TOF sequence combined diagnosis,the difference was statistically significant.98 patients were followed up for 6 months to 2 years.The cure rate was 86.7%,the marked effective rate was 8.2%,the effective rate was 3.1%,and the ineffective rate was 2.0%.Conclusion MR virtual endoscopy can clearly show the three-dimensional spatial relationship between the trigeminal nerve and the responsible vessel and combining 3D-FIESTA and 3D-TOF sequence can significantly improve the sensitivity and accuracy of the judgment of the responsible vessel.It has more advantages for the detection of arterioles and veins,which is an important method for preoperative evaluation of primary trigeminal neuralgia.

关 键 词：三叉神经痛 磁共振成像 仿真内镜 微血管减压术 

分 类 号：R745.1[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]