低场强磁共振CBASS序列在三叉神经痛病因诊断中的应用价值

Evaluation of CBASS in the diagnosis of trigeminal neuralgia

目的:探讨低场强MRI CBASS序列在三叉神经痛(TN)病因中的研究价值。方法:对50例TN患者依次采用CBASS序列,结合FE序列,FE3D-TOF序列进行检查,对CBASS序列成像MRI表现及手术结果作回顾性分析。结果:①50例TN患者中,肿瘤性病变7例,其它3例,排除上述继发性TN10例;40例原发性TN患者入选,疼痛侧MRICBASS序列发现有三叉神经血管压迫或接触29例(29/40),非疼痛侧有三叉神经血管接触9例(9/40),两组相比有显著性差异2=20.050,(P<0.0001);②50例患者均行手术治疗,CBASS序列对原发性TN诊断的敏感性为93.1%,特异性为81.8%,准确性90.01%,假阴性为18.21%,假阳性为6.9%。结论:三叉神经脑池段血管压迫或接触是TN的首要原因,CBASS序列成像能清晰显示三叉神经与邻近血管、肿瘤病变或其他病变之间的关系,对临床诊治具有重要指导意义。

Objective:To study the diagnostic value of CBASS in the investigation of etiology in trigeminal neuralgia(TN).Methods:MR manifestations and surgical results of 50 patients with TN were reviewed retrospectively,using CBASS combined with FE and FE3D-TOF MRI sequence.Results:In 50 cases of patients with TN,neoplastic lesions were found in 7 patients,others in 3 cases;10 cases with secondary TN were roled out.40 patients with primary TN were selected.Pain in the lateral MRI CBASS sequence was found trigeminal nerve vascular compression or contact in 29 cases(29/40),non pain side of trigeminal nerve vascular contact in 9 cases(9/40).The two groups had significant difference(X2=20.050,P<0.0001);① 50 patients were treated with surgical operation.The senstitivity,specifity,accuracy,faese ragtive rate,and false postitive rate were 93%,81.8%,90.0%,18.2%,and 6.9% diagnosed by CBASS sequence,respectively.Conclusion:The cisternal segment of vascular compression or contact of trigminal nerre is the primary cause of TN.CBASS imaging can clearly display the trigeminal nerve and adjacent vascular lesions,tumors or other the relationship between lesion,which has important guiding significance for clinical diagnosis and treatment.