MRI融合技术对提高三叉神经痛伽马刀治疗术前定位的准确性分析  

Analysis of MRI Fusion Technique to Improve the Accuracy of Localization Before Gamma Knife Treatment of Trigeminal Neuralgia

作　　者：苏小蓉 SU Xiao-rong(Department of Imaging,Zhongshan Hospital Xiamen University,Fujian Xiamen 361004)

机构地区：[1]厦门大学附属中山医院影像科,福建厦门361004

出　　处：《中国医疗器械信息》2024年第8期8-11,共4页China Medical Device Information

摘　　要：目的:探讨磁共振成像(MRI)融合技术对提高三叉神经痛伽玛刀治疗术前定位的准确性。方法:选取2020年3月~2022年12月本院三叉神经痛患者94例为研究对象,分别行三维可变反转角快速自选回波(3D-SPACE)及三维时间飞跃磁共振血管成像(3D-TOF-MRA)序列扫描,然后进行信息采集,均行伽玛刀治疗。分析血管和神经关系。结果:与伽玛刀术中比较,3D-SPACE、3D-TOF-MRA、3D-SPACE与3D-TOF-MRA融合成像诊断血管神经压迫的程度轻于术中,Ⅲ级压迫符合率较高,差异具有统计学意义(P<0.05);以伽玛刀术中有无责任血管为标准,3D-SPACE、3D-TOF-MRA、3D-SPACE与3D-TOF-MRA融合成像无责任血管的准确率分别为89.36%(84/94)、91.49%(86/94)、97.87%(92/94);患者患侧的三叉神经面积(2.96±0.83)mm2,明显小于健侧的(5.01±0.34)mm2(P<0.05);两位医师对三种序列三叉神经血管压迫情况评判诊断统一性较强(Kappa值分别是0.67、0.70、0.70,P<0.001)。结论:MRI融合技术提高三叉神经痛伽玛刀治疗术前定位准确性,清晰地显示血管与神经之间的关系,对术前的评估和指导有一定参考价值。Objective:To investigate the accuracy of magnetic resonance imaging(MRI)fusion technology for preoperative localization of trigeminal neuralgia gamma knife treatment.Methods:A total of 94 patients with trigeminal neuralgia in our hospital from March 2020 to December 2022 were selected as research objects.Three-dimensional variable reverse Angle rapid self-selected echo(3D-SPACE)and three-dimensional time-lapse magnetic resonance angiography(3D-TOF-MRA)sequence scanning were performed respectively,and then information was collected.All patients were treated with gamma knife.Vascular and neural relationships were analyzed.Results:Compared with gamma knife surgery,3D-SPACE,3D-TOF-MRA,3D-SPACE and 3D-TOF-MRA fusion imaging in the diagnosis of vascular and nerve compression was less than in surgery,and the coincidence rate of gradeⅢcompression was higher,the difference was statistically significant(P<0.05).The accuracy rates of 3D-SPACE,3D-TOF-MRA,3D-SPACE and 3D-TOF-MRA fusion imaging without responsible vessels were 89.36%(84/94),91.49%(86/94)and 97.87%(92/94),respectively.The area of trigeminal nerve on the affected side was(2.96±0.83)mm2,which was significantly smaller than that on the healthy side(5.01±0.34)mm2(P<0.05).The two physicians had a strong diagnostic unity for the three sequences of trigeminal vascular compression(Kappa values were 0.67,0.70,0.70,P<0.001).Conclusion:MRI fusion technology can improve the accuracy of localization before gamma knife treatment of trigeminal neuralgia and clearly show the relationship between blood vessels and nerves,which has certain reference value for preoperative evaluation and guidance.

关 键 词：三叉神经痛 伽玛刀手术 三维时间飞跃磁共振血管成像 三维可变反转角快速自选回波 准确 性 诊断价值 

分 类 号：R445.2[医药卫生—影像医学与核医学]