弥散张量成像在经皮穿刺半月节球囊压迫术治疗三叉神经痛的应用价值研究  

Application value of diffusion tensor imaging in treatment of trigeminal neuralgia by percutaneous microballoon compression

作　　者：赵硕研 李立[2] 张繁荣 钱伟军 ZHAO Shuo-yan;LI Li;Zhang Fan-rong;QIAN Wei-jun(Graduate School of Xinxiang Medical University,Xinxiang,Henan 453000,China;Department of Medical Imaging,Kaifeng Central Hospital affiliated to Xinxiang Medical University,Kaifeng,Henan 475000,China)

机构地区：[1]新乡医学院研究生院,河南新乡453000 [2]新乡医学院附属开封中心医院医学影像科,河南开封475000

出　　处：《医药论坛杂志》2024年第22期2453-2458,共6页Journal of Medical Forum

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20230796)。

摘　　要：目的利用弥散张量成像(diffusion tensor imaging,DTI)评估单侧三叉神经痛(trigeminal neuralgia,TN)患者经皮穿刺半月节球囊压迫术(percutaneous balloon compression,PBC)前后三叉神经根局部微结构的变化,探讨其是否可用于临床评估PBC疗效。方法对50例行PBC治疗的单侧TN患者行DTI成像,测量其患侧与健侧三叉神经PBC术前及术后3天的部分各向异性分数(fraction,FA)值、表观扩散系数(apparent diffusion coefficient,ADC)值。对手术前后测得的参数值进行统计学分析。采用视觉模拟评分法(visual analogue score,VAS)评价患者PBC前后的疼痛评分情况。结果PBC术后3天患侧三叉神经远段FA值较术前FA值减低(P<0.05),ADC值较术前ADC值增高(P<0.05),差异有统计学意义。三叉神经健侧术前术后FA值、ADC值变化均无统计学意义(P>0.05)。结论三叉神经远段DTI参数(FA值和ADC值)的变化可用于评价三叉神经PBC术后神经微结构变化,可作为评估三叉神经痛PBC术的定量观察指标,对三叉神经痛PBC手术疗效评估具有一定的诊断价值。Objective To evaluate the local microstructural changes of trigeminal nerve roots in patients with unilateral trigeminal neuralgia(TN)before and after percutaneous semilunar balloon compression(PBC)using diffusion tensor imaging(DTI),so as to explore whether DTI can be used in clinical evaluation of the efficacy of PBC.Methods DTI imaging was performed on 50 patients with unilateral TN treated with PBC.Partial anisotropy fraction(FA)and apparent diffusion coefficient(ADC)values of the trigeminal nerve on the affected and healthy side were measured before and 3 days after PBC.The parameter values measured before and after operation were analyzed statistically.Visual analogue score(VAS)was used to evaluate the pain score of patients before and after PBC.Results The FA value of the distal trigeminal nerve was lower than that before operation 3 days after operation(P<0.05),and the ADC value was higher than that before operation(P<0.05).The difference was statistically significant.There was no statistical significance in FA value and ADC value of healthy trigeminal nerve before and after operation(P>0.05).Conclusion The changes of DTI parameters(FA values and ADC values)of the distal segment of the trigeminal nerve can be used to evaluate the changes of nerve microstructure after PBC,and can be used as a quantitative observation index to evaluate the therapeutic effect of PBC for trigeminal neuralgia.

关 键 词：三叉神经痛 脱髓鞘 经皮穿刺球囊压迫术 磁共振弥散张量成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]