三维时间飞跃法磁共振血管成像序列联合磁共振三维稳态进动快速成像对三叉神经痛的诊断价值  

Diagnostic value of 3D-TOF-MRA combined with 3D-FIESTA in trigeminal neuralgia

作　　者：苏兰芳 何占平[2] 陈红 孙丽春 万江花[1] 刘旭东[1] 张业雨 陈春美 SU Lan-fang;HE Zhanping;CHEN Hong(Department of Radiology,The First Affiliated Hospital of Hainan Medical University,Haikou 570102,China.;不详)

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]中南大学湘雅医学院附属海口医院放射科,海南海口570208

出　　处：《中国医学装备》2022年第11期84-88,共5页China Medical Equipment

基　　金：海南省卫生健康行业科研项目(20A200272)“增强3D-TOF-MRA结合3D-FIESTA术前诊断三叉神经痛的临床意义”。

摘　　要：目的:探讨三维时间飞跃法磁共振血管成像(3D-TOF-MRA)序列联合磁共振三维稳态进动快速成像(3D-FIESTA)对三叉神经痛(TN)的诊断价值。方法:选取医院收治的86例TN患者,所有患者均行3D-TOF-MRA和3D-FIESTA检查,以显微血管减压术(MVD)为诊断“金标准”,评估3D-TOF-MRA、3D-FIESTA以及二者联合检查责任血管的阳性预测值及阴性预测值,采用受试者工作特征(ROC)曲线下面积(AUC)对比分析TN责任血管情况。结果:在86例TN患者中,经MVD确诊TN责任血管80例,未见TN责任血管6例,经3D-TOF-MRA检测TN责任血管阳性预测值和阴性预测值分别为94.59%和16.67%;经3D-FIESTA检测阳性预测值和阴性预测值分别为94.44%和14.29%;经3D-ToF-MRA联合3D-FIESTA检测分别为97.50%和66.67%。3D-TOF-MRA联合3D-FIESTA检测准确率及灵敏度均高于3D-TOF-MRA和3D-FIESTA单项检测,漏诊率低于3D-TOF-MRA和3D-FIESTA单项检测,差异有统计学意义(χ^(2)=8.401,χ^(2)=7.778,χ^(2)=7.778;P<0.05);3D-TOF-MRA联合3D-FIESTA检测误诊率低于3D-TOF-MRA和3D-FIESTA单项检测,而特异度高于3D-TOF-MRA和3D-FIESTA单项检测,但差异无统计学意义。3D-TOF-MRA、3D-FIESTA及两项联合诊断TN责任血管的AUC值分别为0.604、0.592和0.821。结论:3D-TOF-MRA联合3D-FIESTA在TN诊断中具有互补作用,既能明确责任血管的存在,又能明确其血管类型,对制定手术方案具有指导意义。Objective:To explore the diagnostic value of three dimensional time of flight magnetic resonance angiography(3D-TOF-MRA)combined with three-dimensional fast imaging employing steady state acquisition(3D-FIESTA)for trigeminal neuralgia(TN).Methods:Eighty-six TN patients who admitted to hospital were selected.All patients underwent 3D-TOF-MRA and 3D-FIESTA examinations.Microvascular decompression(MVD)was used as the gold standard to assess the positively and negatively predictive values of 3D-TOF-MRA,3D-FIESTA and their combined examination on responsible vessels.The area under curve(AUC)of receiver operating characteristics(ROC)curve was adopted to compare and analyze the condition of responsible vessels.Results:In 86 TN patients,the responsible vessels of 80 cases were confirmed by MVD,and there was no responsible vessel in 6 cases.The positively and negatively predictive value of 3D-TOF-MRA on responsible vessels were 94.59%and 16.67%,respectively.The positively and negatively predictive values of 3D-FIESTA were 94.44%and 14.29%.The positively and negatively predictive values of 3D-TOF-MRA combined with 3D-FIESTA were 97.50%and 66.67%,respectively.The accuracy and sensitivity of 3D-TOF-MRA combined with 3D-FIESTA were significantly higher than those of single 3D-TOF-MRA and single 3D-FIESTA,respectively,while the missed diagnosis rates of combined examination was significantly lower than that of single 3D-TOF-MRA and single 3D-FIESTA(χ^(2)=8.401,χ^(2)=7.778,χ^(2)=7.778,P<0.05).The misdiagnosis rate of combined examination was significantly lower than that of single 3D-TOF-MRA and single 3D-FIESTA.The specificity of combined examination was higher than that of single 3D-TOF-MRA and single 3D-FIESTA,while the difference was not statistically significant.The AUC values of 3D-TOF-MRA,3D-FIESTA and the combination of them were respectively 0.604,0.592 and 0.821 in diagnosing TN responsible vessels.Conclusion:3D-TOF-MRA combined with 3D-FIESTA has complementary effects in the diagnosis of trigeminal neuralgia.It ca

关 键 词：三维时间飞跃法磁共振血管成像序列(3D-TOF-MRA) 磁共振三维稳态进动快速成像(3D-FIESTA) 三叉神经痛(TN) 显微血管减压术(MVD) 

分 类 号：R745.11[医药卫生—神经病学与精神病学]