MRI迷路水神经成像对三叉神经痛神经血管压迫的诊断价值  

Diagnostic value of MRI labyrinth hydroneuroimaging on neurovascular compression in trigeminal neuralgia

作　　者：张璐 张梦诗 刘烨 任静 黎庆 盛金平 ZHANG Lu;ZHANG Mengshi;LIU Ye;REN Jing;LI Qing;SHENG Jinping(Department of Diagnostic Radiology,Western Theater General Hospital,Chengdu 610083,China)

机构地区：[1]西部战区总医院放射诊断科,四川成都610083

出　　处：《分子影像学杂志》2023年第1期70-73,共4页Journal of Molecular Imaging

基　　金：四川省科技厅重点研发项目(2018fz0065)。

摘　　要：目的探究MRI迷路水神经成像诊断三叉神经痛和神经血管压迫的效果。方法回顾性分析我院168例三叉神经痛患者的临床资料,均行手术治疗证实,且进行MRI迷路水神经成像检查,分析患者神经血管压迫的影像学检查结果,与手术结果对比,并比较患者三叉神经池段形态学参数(三叉神经脑池段最大长度及面积、三叉神经-桥脑夹角、桥小脑角池截面)。结果168例三叉神经痛患者中MRI成像检测处左侧受压80例,与临床左侧三叉神经痛分布区的相符率为90.91%,右侧受压74例,与临床右侧三叉神经痛分布区的相符率为92.50%,未见压迫14例;患侧和健侧压迫位置的差异无统计学意义(P>0.05);主要压迫动脉为中小脑上动脉,占70.83%(119/168);患侧压迫程度较高(P<0.05);两侧三叉神经最大长度的差异无统计学意义(P>0.05),患侧三叉神经横截面积、三叉神经桥脑夹角、桥小脑角池截面积较低(P<0.05)。结论MRI迷路水神经成像能够有效诊断三叉神经痛,显示神经周围具体情况,判断三叉神经脑池段形态学改变,为临床三叉神经痛神经血管压迫的诊断提供依据。Objective To explore the effect of MRI labyrinth hydroneuroimaging in the diagnosis of trigeminal neuralgia and neurovascular compression.Methods Retrospective analysis was performed on clinical data of 168 patients with trigeminal neuralgia in the hospital.All patients were confirmed by surgical treatment and performed MRI labyrinth hydroneuroimaging.The imaging examination results of neurovascular compression were analyzed and compared with the surgical results.The morphological parameters of the trigeminal cistern segment(maximum length and area of the trigeminal cisternal segment,trigeminal nerve-pontine angle,cerebellopontine angle cistern section)were compared among the patients.Results Among the 168 patients with trigeminal neuralgia,80 cases were compressed on the left side by MRI imaging detection,which was 90.91%consistent with the clinical distribution of left trigeminal neuralgia,and 74 cases were compressed on the right side which was 92.50%consistent with the clinical distribution of right trigeminal neuralgia.No compression was observed in 14 cases.There was no significant difference in the compression position between the affected and healthy sides(P>0.05).The main compression artery was the middle superior cerebellar artery,accounting for 70.83%(119/168).The degree of compression on the affected side was higher(P<0.05).There was no significant difference in the maximum length of trigeminal nerve between the two sides(P>0.05),and the cross-sectional area of trigeminal nerve,trigeminal nerve-pontine angle and cross-sectional area of cerebellopontine angle cistern were smaller in the affected side(P<0.05).Conclusion MRI labyrinth hydroneuroimaging can effectively diagnose trigeminal neuralgia,show the specific conditions around the nerve,judge the morphological changes of the trigeminal cisternal segment.It can provide a basis for the diagnosis of neurovascular compression in clinical trigeminal neuralgia.

关 键 词：三叉神经痛 神经血管压迫 磁共振成像 水神经成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R745.11[医药卫生—诊断学]