MRI探讨颅神经疾病的发生机制及其对微血管减压手术的指导意义

Guidance significance of MRI scan for microvascular decompression therapy of brain nerve disease

目的利用MRI检查探讨颅神经疾病的发生机理以及对微血管减压手术的指导价值。方法观察手术治疗251例颅神经疾病患者与60例正常对照组核磁共振检查结果,评价异位血管压迫在颅神经疾病发生发展中的作用,观察脑池段三叉神经、面神经长度及蛛网膜下腔宽度,以及面神经和脑干位置关系对手术难易程度的影响。结果颅神经疾病患者患侧与健侧,患者患侧与健康人群血管神经接触关系有显著差异;三叉神经、面神经长度,蛛网膜下腔宽度以及面神经与与脑干位置关系都对手术的难度产生影响。结论MRI-3DFFE序列检查能清晰显示生理状态下神经血管关系。神经血管压迫与颅神经疾病发生发展有密切关系。术前MRI检查对指导微血管减压手术及预测手术难度有重要的指导意义。

Objective To investigate the results of MRI scan and study the pathogenology of brain nerve disease and the value of MRI scan for microvascular decompression operation. Methods 251 nerve disease patients performed with microvascular decompression operation were collected, and with 60 healthy control group. Their MRI manifestations before operation of affected side to healthy side and healthy control group were analyzed respectively. The length of intracisternal segment of trigeminal nerve and facial nerve were measured. Also the angle between the facial nerve and the median sagittal line were measured. And analyzed their relationship to operation time. Results The relationship of nerve and vascular was significant in the affected side and healthy side of patients with brain nerve disease. Also the MRI manifesitations of patients and control group was significant. The length of intracisternal segment of trigeminal nerve , fa- cial nerve and the angle between the facial nerve and the median sagittal line affected the difference of opertation. Conclusion Preoperative MRI--3DFFE scan may estimate operation difficulty. And it is useful for patient selection and treatment effect improvement. MRI has great value in microvascular decompression operation.