3D-TSE序列结合DRIVE诊断面肌痉挛病因的价值

Evaluation of 3D-TSE with Drive in the diagnosis of hemifacial spasm

目的:探讨MRI三维快速自旋回波序列(3D-TSE)加入DRIVE脉冲对面肌痉挛(HFS)患者的病因诊断及图像质量改善的价值。方法:应用3D-TSE及加入DRIVE脉冲的序列,对55例HFS患者行桥小脑角薄层扫描,并行后颅窝探察术,分析HFS患者桥小脑角区面神经与周围血管等结构的关系,并与手术结果进行对照。结果:(1)MRI诊断面肌痉挛病因中血管压迫占95%(52/55),神经源肿瘤占3.6%(2/55),其它占1.8%(1/55)。HFS患者痉挛侧与非痉挛侧的血管神经压迫差异有统计学意义(P<0.005)。(2)3D-TSE序列与加入DRIVE脉冲序列比较,可以将扫描时间缩短50%,图像质量明显改善。手术结果表明,3D-TSE序列对面肌痉挛患者诊断的敏感性为96%,特异性为100%;3D-TSE加入DRIVE脉冲序列对面肌痉挛患者诊断的敏感性为98%,特异性为100%。结论:面神经脑池段的血管压迫是面肌痉挛的主要病因,3D-TSE加入DRIVE脉冲可以明显提高图像质量,缩短扫描时间,值得推广应用。

Objective： To evaluate the diagnostic value of 3D-TSE with DRIVE in the investigation of etiologyof hemifacial spasm（HFS）. Methods： Fifty-five patients with hemifacial .spasm （HFS） referable to the cerebellopontine angle （CPA） were examined using a T2 3D-TSE with Drive. Image was performed on a 1, 5-T MR scanner （Phillitp Gyroscan）. Exploiting a 0. 7 mm slice thickness in the axial images scanned the CPA and IAC, oblique coronal images of the inner ear were evaluated. MR manifestations and operative identification of 55 patients with HFS were compared retrospectively. Results： Out of 55 patients investigated, there are 52 were detected with on symptomatic sides concerning neurovascular compression and the involved vessels. The left two patients suffered with tiny intracanalicular tumors, which located on those nerves could be identified. The percentages of the neurovascular contact and tumors were 95% （52/55） and 3, 6%（2/55） respectively. The sensitivity and specificity of 3D-TSE and 3D-TSE with DRIVE diagnosis was 96% ,100% and 98%. 100% respectively. Conclusion： Intraoperative inspection revealed that the ficial nerve root was in contact with a small arterial loop at its cistcrnal course and deformed as demonstrated by preoperative T2 3D-TSE with Drive. So this technique plays an important role in imaging small structuresor tumors relate to the vascular surrounding facial nerve. With high contrast and resolution, this technique determines the sensitivity and giving recommendations on the most suitable technique to visualize ,preview and review the operation for the patient with HFS.