MRI不同成像序列在血管压迫性三叉神经痛诊断中的应用价值  

Application Value of Different MRI Imaging Sequences in the Diagnosis of Vascular Compression Trigeminal Neuralgia

作　　者：曹晓明 章凯玉 CAO Xiaoming;ZHANG Kaiyu(Xianning First People's Hospital,Xianning 437000,China;不详)

机构地区：[1]咸宁市第一人民医院,湖北咸宁437000

出　　处：《中外医学研究》2024年第4期62-66,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨MRI不同成像序列在血管压迫性三叉神经痛诊断中的应用价值。方法:选取2018年3月—2019年6月咸宁市第一人民医院收治的58例三叉神经痛患者作为研究对象。所有患者行微血管减压(MVD)术前均进行MRI颅脑扫描,首先行MRI平扫,再采用三维快速平衡稳态成像(3D-FIESTA)序列、三维时间飞跃破坏性稳态梯度回波(3D-TOFSPGR)序列进行扫描,之后静脉注射钆喷酸葡胺注射液,最后再次采用3D-TOF-SPGR序列进行扫描,即为增强三维时间飞跃破坏性稳态梯度回波(3D-CE-TOF-SPGR)序列。以MVD术中所见神经与血管的关系作为金标准,计算三种序列在患者神经与血管关系判断中的敏感度、特异度、准确度、阳性预测值和阴性预测值,分别计算三种序列与MVD术中所见的诊断一致性。再以MVD术中所见责任血管的情况作为金标准,计算三种序列对责任血管的显示率。结果:三种序列对神经与血管关系的敏感度、准确度和阴性预测值排序均为:3D-CE-TOF-SPGR>3D-TOF-SPGR>3D-FIESTA,三种序列的特异度、阳性预测值均为100.0%。3D-FIESTA序列的Kappa值<0.4,与MVD术结果的一致性较差;3D-TOF-SPGR与3D-CE-TOFSPGR序列的Kappa值在0.4~0.7,与MVD术结果的一致性中等,且3D-CE-TOF-SPGR序列最优。三种序列对单支动脉责任血管的显示率均较高,其中3D-TOF-SPGR和3D-CE-TOF-SPGR序列达到了100.0%,而两支及两支以上动脉、动静脉复合的责任血管显示率均以3D-CE-TOF-SPGR序列最高。结论:与3D-FIESTA和3D-TOF-SPGR序列相比,3D-CE-TOF-SPGR序列具有更高的诊断效能,且能更清晰地显示责任血管。Objective:To investigate the application value of different MRI sequences in the diagnosis of vascular compression trigeminal neuralgia.Method:Fifty-eight patients with trigeminal neuralgia who admitted to Xianning First People's Hospital from March 2018 to June 2019 were selected as research objects.All patients underwent MRI brain scan before microvascular decompression(MVD),MRI plain scan was performed first,then,three-dimensional fast equilibrium steady-state imaging(3D-FIESTA)sequence and three-dimensional time-of-flight destructive steady-state gradient echo(3D-TOF-SPGR)sequence were used for scanning,and then Gadopentetate Dimeglumine Injection was intravenously injected,finally,3D-TOF-SPGR sequence was used for scanning again,that is,the enhanced three-dimensional time-of-flight destructive steady-state gradient echo(3D-CE-TOF-SPGR)sequence.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of three sequences in the judgment of the relationship between the nerve and blood vessel of patients were calculated by using the relationship between nerve and blood vessel seen in MVD as the gold standard,and the consistency among three sequences and the diagnosis seen in MVD was calculated respectively.Then,the display rate of the three sequences to the responsible vessels was calculated according to the golden standard.Result:The sensitivity,accuracy and negative predictive value of three sequences were:3D-CE-TOF-SPGR>3D-TOF-SPGR>3D-FIESTA,the specificity and positive predictive value of three sequences were all 100.0%.The Kappa value of 3D-FIESTA sequence was less than 0.4,which was not consistent with MVD results;the Kappa value of 3D-TOF-SPGR and 3D-CE-TOF-SPGR sequence were between 0.4 and 0.7,which was consistent with MVD results moderately,and 3D-CE-TOF-SPGR sequence was the best.The display rate of three sequences for single artery were higher,among which 3D-TOF-SPGR and 3D-CE-TOF-SPGR sequences reached 100.0%,while 3D-CE-TOF-SPGR sequence was the highest for two or

关 键 词：三叉神经痛 血管压迫 磁共振断层血管成像 三维时间飞跃 

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]