MRI三维重建技术在颅神经血管压迫综合征中的应用价值  

The value of three-dimensional MRI reconstruction in cranial neurovascular compression syndrome

作　　者：李丹[1] 刘阳 雷苗 李传坤[3] 张明[2] 王渊[2] LI Dan;LIU Yang;LEI Miao;LI Chuankun;ZHANG Ming;WANG Yuan(Department of Respiratory and Critical Care Medicine,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of Medical Imaging,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Department of Neurosurgery,The First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China)

机构地区：[1]西安交通大学第一附属医院呼吸与危重症医学科,陕西西安710061 [2]西安交通大学第一附属医院医学影像科,陕西西安710061 [3]西安交通大学第一附属医院神经外科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2024年第5期844-850,共7页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金项目(No.81301207,82171909);陕西省重点研发计划项目(No.2021SF-091)。

摘　　要：目的探讨MRI三维重建技术在颅神经血管压迫综合征责任血管识别和神经受压判定中的应用价值。方法在微血管减压术前对91例三叉神经痛及72例面肌痉挛患者行桥小脑角池段颅神经和血管成像,将获得的MRI原始数据分别进行二维和三维水平(曲面及仿真内窥镜)重建,多维度评价责任血管的数目、来源和颅神经受压程度,并将影像诊断结果与术中所见进行比较。结果三维重建技术对三叉神经痛责任血管的正确识别率为95.6%,对血管压迫神经判定的准确性为94.5%。此技术对面肌痉挛责任血管的正确识别率为91.7%,对血管压迫神经判定的准确性为89.5%。三维重建技术对责任血管与颅神经单纯性接触的判定准确率明显高于二维图像(P<0.05)。结论MRI三维重建技术可以提高责任血管识别的正确率,更加准确地检测颅神经受压程度,对于多支责任血管造成的颅神经复杂性压迫更为适用。Objective To investigate the application value of MRI three-dimensional reconstruction techniques in the identification of offending vessels and affected nerves in cranial neurovascular compression syndrome.Methods A total of 91 patients with trigeminal neuralgia and 72 patients with hemifacial spasm underwent FIESTA and TOF-MRA scanning before microvascular decompression.Two-dimensional and three-dimensional reconstruction techniques(curved planar reconstruction and MR virtual endoscopy)were respectively performed using the original MRI data so as to evaluate the number and category of offending vessels and the degree of compression on cranial nerves.The results of imaging diagnosis were compared with the observations during neurosurgery.Results The correct identification rate of the offending vessels in trigeminal neuralgia was 95.6%by 3D reconstruction technique,wit h 94.5%diagnostic accuracy of neurovascular compression.In addition,the accurate identification rate was 91.7%on the detection of the offending vessels in hemifacial spasm,with 89.5%accuracy of the judgment on neurovascular compression.It should be noted that the diagnostic accuracy for the simple contact between the offending blood vessels and the cranial nerves using 3D reconstruction was significantly higher than that of the evaluation through 2D observation(P<0.05).Conclusion 3D reconstruction technique can improve the accuracy of offending blood vessels identification and provide more reliable information on the degree of cranial nerve distortion or atrophy.Therefore,3D MRI images are more suitable for investigating the complex neurovascular compression.

关 键 词：颅神经血管压迫综合征 责任血管 曲面重建 仿真内窥镜 

分 类 号：R741.04[医药卫生—神经病学与精神病学]