磁共振三维稳态进动快速成像与MRI迷路水神经成像诊断三叉神经痛血管压迫的临床对比分析  

Clinical Comparative Analysis of Three-dimensional Fast Imaging Employing Steady-state Acquisition and MRI Labyrinthine Water Nerve Imaging in the Diagnosis of Trigeminal Neuralgia Vascular Compression

作　　者：付银霞 王红 赵副皓 FU Yinxia;WANG Hong;ZHAO Fuhao(Department of Medical Imaging,Xingyi People's Hospital,Xingyi 562400,Guizhou,China)

机构地区：[1]兴义市人民医院医学影像科,贵州兴义562400

出　　处：《世界复合医学(中英文)》2025年第3期185-189,共5页World Journal of Complex Medicine

摘　　要：目的 分析磁共振三维稳态进动快速成像(three-dimensional fast imaging employing steadystate acquisition,3D-FIESTA)与MRI迷路水神经成像检查三叉神经痛血管压迫的结果。方法 选取2022年1月—2024年1月兴义市人民医院诊治的179例三叉神经痛患者,均进行MRI迷路水神经成像检查和3D-FIESTA,以手术结果为金标准。对比两种检查单独诊断与联合诊断三叉神经痛血管压迫的结果。结果 在179例患者中,手术结果共诊断出82例阳性,97例阴性。MRI迷路水神经成像、3D-FIESTA以及两者联合诊断的kappa值分别为0.809、0.761、0.909。提示3种诊断均具有较好的一致性。两者联合诊断的准确度、灵敏度、特异度高于迷路水神经成像和3D-FIESTA单独诊断,差异均有统计学意义(P均<0.05)。3种检查方式对基底动脉、小脑上动脉和小脑后下动脉的诊断符合率比较,差异均无统计学意义(P均>0.05)。联合检查对小脑前下动脉压迫责任血管的诊断符合率为94.44%(17/18),高于MRI迷路水神经成像和3D-FIESTA的88.89%(16/18)、61.11%(11/18),差异有统计学意义(χ^(2)=7.609,P<0.05)。结论 3D-FIESTA联合MRI迷路水神经成像,在提高三叉神经痛血管压迫诊断的准确度、灵敏度和特异度方面具有明显优势,尤其在小脑前下动脉作为责任血管的诊断上表现更为突出。Objective The results of three-dimensional fast imaging employing steady-state acquisition(3D-FIESTA) and MRI labyrinthine water nerve imaging for trigeminal neuralgia vascular compression were analyzed.Methods From January 2022 to January 2024,179 patients with trigeminal neuralgia diagnosed and treated in Xingyi People's Hospital were selected.All patients underwent MRI labyrinthine water neuroimaging and 3D-FIESTA.The surgical results were the gold standard.The results of single diagnosis and combined diagnosis of vascular compression in trigeminal neuralgia were analyzed.Results Among 179 patients,82 cases positive were diagnosed by surgical results,and 97 cases negative.The kappa values of MRI labyrinthine water nerve imaging,3D-FIESTA and their combined diagnosis were 0.809,0.761 and 0.909,respectively.It is suggested that the three diagnoses have good consistency.The accuracy,sensitivity and specificity of combined diagnosis were higher than those of labyrinthine water nerve imaging and 3D-FIESTA alone,and the differences were statistically significant(all P<0.05).There were no significant differences between the three methods in the diagnostic accuracy rate of basilar artery,superior cerebellar artery and posterior inferior cerebellar artery(all P>0.05).The diagnostic coincidence rate of combined examination for responsible vessels of anterior inferior cerebellar artery compression was 94.44%(17/18),which was higher than 88.89%(16/18) and 61.11%(11/18) of MRI labyrinthine water nerve imaging and 3D-FIESTA,and the difference was statistically significant(χ2=7.609,P<0.05).Conclusion 3D-FIESTA combined with MRI labyrinthine water nerve imaging has obvious advantages in improving the accuracy,sensitivity and specificity of vascular compression diagnosis of trigeminal neuralgia,especially in the diagnosis of anterior inferior cerebellar artery as the responsible vessel.

关 键 词：磁共振成像 磁共振三维稳态进动快速成像 MRI迷路水神经成像 三叉神经痛 神经血管压迫 

分 类 号：R745[医药卫生—神经病学与精神病学]