3D-slicer在评估三叉神经萎缩中的作用  

Role of 3D-Slicer in Evaluating Trigeminal Nerve Atrophy

作　　者：李洋[1] 石海亮[1] 张阔[1] 王文良 杨嗣徽 钱涛[1] LI Yang;SHI Hailiang;ZHANG Kuo(Department of Neurosurgery,Hebei People's Hospital,Shijiazhuang,Hebei Province 050051,P.R.China)

机构地区：[1]河北省人民医院神经外科,石家庄050051 [2]承德医学院,067000

出　　处：《临床放射学杂志》2023年第3期378-383,共6页Journal of Clinical Radiology

基　　金：河北省卫生健康委重点科技研究计划(编号:20190230)。

摘　　要：目的探讨通过3D-slicer处理后的三维时间飞跃法磁共振血管成像(3D-TOF-MRA)和三维稳态采集快速成像序列(3D-FIESTA)对三叉神经萎缩评估的作用。方法搜集38例三叉神经痛患者(实验组)和38例面肌痉挛患者(对照组)纳入研究。所有患者均进行3D-TOF-MRA和3D-FIESTA序列检查,通过3D-slicer进行图像融合,比较两组双侧的三叉神经体积。结果实验组患侧三叉神经体积(77.74±11.31)mm3小于实验组非患侧(78.42±14.43)mm3(P<0.01)和对照组(80.23±23.31)mm3,95%CI:77.10~83.37 mm3(P<0.01)。实验组的三叉神经体积差异ΔV为(15.40±9.07)%大于对照组ΔV=(5.42%±3.20)%(P<0.01)。责任血管压迫TREZ、MC、JP不同部位的两侧三叉神经ΔV(17.86±11.28)%、(13.02±3.87)%、(7.73±4.72)%,差异有统计学意义(P=0.045);TREZ与JPΔV差异明显,差异有统计学意义(P=0.006)。对Ⅰ级压迫、Ⅱ级压迫、Ⅲ级压迫,ΔV分别为(7.33±5.09)%、(12.47±4.85)%、(25.12±9.85)%,差异有统计学意义(P<0.01)。且三叉神经萎缩程度与术后预后情况成正相关(OR=0.900,P<0.05)。结论三叉神经萎缩与三叉神经痛有一定的相关性,其萎缩程度在三叉神经不同压迫部位及压迫程度中存在差异,且可考虑作为一个预测术后预后的观察指标。Objective To investigate the effect of 3D-slicer-treated tree dimensional time-of-flight magnetic resonance angiography(3D-TOF-MRA)and tree dimensional fast imaging employing steady state acquisition sequence(3D-FIESTA)on the assessment of trigeminal nerve atrophy.Methods A total of 38 patients with trigeminal neuralgia and 38 patients with hemifacial spasm admitted were included in the study.All patients underwent 3D-TOF-MRA and 3D-FIESTA sequence examination,and image fusion was performed by 3D-Slicer to compare bilateral trigeminal nerve volumes between the two groups.Results The volume of trigeminal nerve in the affected side of the experimental group(77.74±11.31)mm3 was smaller than that in the non-affected side of the experimental group(78.42±14.43)mm3(P<0.001)and the control group(80.23±23.31)mm3,95%CI:77.10-83.37)mm3.(P<0.01).The volume difference of trigeminal nerve in the experimental group is(15.40±9.07)%higher than that in the control group,ΔV=(5.42±3.20)%(P<0.01).There were statistically significant differences(P=0.045)between the two trigeminal nerveΔV were(17.86±11.28)%,(13.02±3.87)%and(7.73±4.72)%of TREZ,MC and JP.TREZ and JPΔV were significantly different(P=0.006).For gradeⅠcompression,gradeⅡcompression and gradeⅢcompression,theΔV were(7.33±5.09)%,(12.47±4.85)%and(25.12±9.85)%,respectively,and the differences were statistically significant(P<0.01).The degree of trigeminal nerve atrophy was positively correlated with the postoperative prognosis(OR=0.900,P<0.05).Conclusion Trigeminal nerve atrophy is associated with trigeminal neuralgia,and its degree of atrophy varies among different compression sites and compression sites on the trigeminal nerve,and it may be considered as an observational indicator for predicting postoperative prognosis.

关 键 词：三叉神经痛 萎缩 责任血管 三维时间飞跃法磁共振血管成像 三维双激发平衡式稳态自由进动序列 3D-slicer 

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]