Meckel's腔形状与PBC术中球囊形状、压力关系的研究  

Investigation of the correlation between Meckel's cavity shape,balloon shape,and intracapsular pressure in percutaneous balloon compression

作　　者：徐阳 王瀚轩 张岩松[1] 夏炎 朱帅帅 罗正祥[1] XU Yang;WANG Hanxuan;ZHANG Yansong;XIA Yan;ZHU Shuaishuai;LUO Zhengxiang(Department of Neurosurgery,Nanjing Brain Hospital Affiliated to Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学附属脑科医院神经外科,南京210029 [2]河北省人民医院神经外科

出　　处：《临床神经外科杂志》2025年第2期205-209,共5页Journal of Clinical Neurosurgery

基　　金：国家自然科学基金面上项目(81874081);南京市医学科技发展项目(YKK21117)。

摘　　要：目的 探讨Meckel's腔形状与经皮球囊压迫术(PBC)术中球囊形状、压力的关系。方法 回顾性分析2020年9月—2022年2月在南京医科大学附属脑科医院接受PBC手术治疗的58例典型三叉神经痛患者。术前利用磁共振(MRI)3D-FIESTA薄层扫描序列重建分析Meckel's腔矢状面的特征。术中连续记录球囊“梨形”成形时的压力,并测量球囊的高度/长度比。通过多种参数分析Meckel's腔形状与球囊形状及囊内压力之间的关系。结果 57例患者术后疼痛即刻缓解,有效率达98.28%;中位随访时间7.5个月,复发2例,复发率3.4%。MRI评估显示,Meckel's腔棍球型占31.1%,卵圆型占58.6%,扁平型占10.3%。囊内压力与Meckel's腔高度/长度比呈显著负相关。球囊高度/长度比与Meckel's腔高度/长度比无统计学差异。结论 术前通过MRI 3D-FIESTA薄层扫描序列重建评估Meckel's腔矢状面形状,结果表明囊内压力与Meckel's腔高度/长度比呈负相关;球囊“梨形”成形的形状与Meckel's腔矢状位形状的相关性较低。Objective To investigate the relationship between Meckel's cavity shape,balloon shape and intracapsular pressure during percutaneous balloon compression(PBC).Methods Fifty-eight patients with typical trigeminal neuralgia who underwent PBC in Department of Neurosurgery,Nanjing Brain Hospital Affiliated to Nanjing Medical University from September 2020 to February 2022 were analyzed retrospectively.Magnetic resonance imaging(MRI) 3D-FIESTA thin-layer scanning sequence reconstruction was performed before operation to analyze the sagittal features of Meckel's cave.The pressure when balloon “pear shaped” forming was recorded continuously during operation,and the balloon height/length ratio was measured.The relationship between the shape of the Meckel's cave cavity,the shape of the balloon,and the internal pressure within the balloon was analyzed through multiple parameters.Results The pain of 57 patients was relieved immediately after operation,and the effective rate was 98.28%.Recurrence occurred in 2 cases and the recurrence rate was 3.5% with the 7.5 months median following time.Classification of Meckel's cave on magnetic resonance imaging showed the clubbing type accounted for(31.1%),oval type(58.6%),flat type(10.3%).The intracavitary pressure was significantly negatively correlated with the height/length ratio of Meckel's cave.There was no statistically significant difference between the height/length ratio of the balloon and that of Meckel's cave.Conclusions Preoperative evaluation of the sagittal shape of Meckel's cave is conducted using 3D-FIESTA thin-slice MRI reconstruction.The results indicate a negative correlation between intracavitary pressure and the height/length ratio of Meckel's cave.However,the correlation between the “pear shaped” balloon formation and the sagittal shape of Meckel's cave is relatively low.

关 键 词：三叉神经痛 经皮球囊压迫术 Meckel's腔 “梨形”球囊 

分 类 号：R651[医药卫生—外科学]