多模态磁共振影像技术评估原发性三叉神经痛责任血管的应用价值  

The Application Value of Multimodal Magnetic Resonance Imaging in Evaluating Rvessels of Ptrigeminal Neuralgia

作　　者：邓政豪 王金宝 陈小翠[1] 刘伟波[1] DENG Zhenghao;WANG Jinbao;CHEN Xiaocui;LIU Weibo(Imaging Center,Yingde People's Hospital,Guangdong 513000,China)

机构地区：[1]英德市人民医院影像中心,广东513000

出　　处：《影像技术》2025年第2期24-28,共5页Image Technology

基　　金：清远市2022年科技计划项目(221109127680961)。

摘　　要：目的:探讨多模态磁共振影像技术在诊断原发性三叉神经痛(PTN)及评估责任血管中的应用价值。方法:选择2021年11月-2023年6月英德市人民医院收治的PTN患者80例。术前均进行平扫与增强T1加权三维磁化强度预备梯度加波(T1WI 3D MPRAGE)序列、磁共振断层血管成像(MRTA)、三维稳态采集快速成像(3D-FIESTA)、扩散张量成像(DTI)检查,以显微血管减压手术(MVD)所见为金标准,评估T1WI 3D MPRAGE、MRTA、3D-FIESTA、DTI及四者联合检测责任血管的阳性率,选择受试者工作特征(ROC)曲线下面积(AUC)对比分析PTN责任血管情况。结果:经T1WI 3D MPRAGE、MRTA、3D-FIESTA、DTI及MRI多模态联合检测的神经—血管压迫(NVC)的阳性率分别为82.43%、81.08%、83.78%、82.43%和97.30%,MRI多模态联合检查NVC的阳性率均明显高于单项检查(P<0.05)。MRI多模态联合检测单支血管符合率为98.41%(62/63),多支血管符合率90.91%(10/11),均高于单项检查(P<0.05)。ROC曲线分析显示,MRI多模态联合检查评估PTN责任血管的AUC值为0.873。结论:MRI多模态影像技术在PTN诊断中可互为补充,既可以确定责任血管的存在,又可以对血管类型做出评价,对MVD具有指导意义。Objective:To investigate the application value of multimodal magnetic resonance imaging in diagnosis of primary trigeminal neuralgia(PTN)and assessment of responsible vessels.Methods:A total of 80 PTN patients admitted to Yingde People's Hospital from November 2021 to June 2023 were selected.Normal scan and enhanced T1WI 3D magnetization preparation gradient plus(T1WI 3D MPRAGE)sequence,magnetic resonance tomography angiography(MRTA),three-dimensional fast imaging employing steady-state acquisition(3D-FIESTA),diffusion tensor imaging(DTI)were performed before surgery.Microvascular decompression(MVD)findings were used as the gold standard.The positive rate of T1WI 3D MPRAGE,MRTA,3DFIESTA,DTI and the combination of the four techniques to detect the responsible vessels,and the area under receiver operating characteristic(ROC)curve(AUC)was selected to compare and analyze the PTN responsible vessels.Results:The positive rates of neurovascular compression(NVC)detected by T1WI 3D MPRAGE,MRTA,3D-FIESTA,DTI and MRI were 82.43%,81.08%,83.78%,82.43%and 97.30%,respectively.The positive rate of NVC in MRI multimodal combined examination was significantly higher than that in single examination(P<0.05).The coincidence rate of single vessel and multi-vessel were 98.41%(62/63)and 90.91%(10/11)respectively,both of which were higher than that of single examination(P<0.05).ROC curve analysis showed that the AUC value of PTN responsible vessels assessed by MRI multimodal combined examination was 0.873.Conclusion:MRI multimodal imaging technology can complement each other in the diagnosis of PTN,which can not only determine the existence of responsible blood vessels,but also evaluate the type of blood vessels,which has guiding significance for MVD.

关 键 词：磁共振 多模态影像 原发性 三叉神经痛 

分 类 号：R445.2[医药卫生—影像医学与核医学]