三叉神经痛的磁共振扩散张量成像研究

Study of trigeminal neuralgia with magnetic resonance diffusion tensor imaging

目的 研究血管压迫三叉神经桥池段的扩散张量成像（DTI）表现及临床应用价值.方法 对60例经手术证实的因责任血管压迫引起三叉神经痛（TN）患者（TN组）和50例健康志愿者（对照组）行常规MRI和横轴面DTI成像,测量其表观扩散系数（ADC）值、部分各向异性分数（FA）值. 结果 对照组的三叉神经的ADC值为（1.76±0.98）×10-3 mm2/s,FA值为0.40±0.18,左侧与右侧三叉神经桥池段的ADC值和FA值差异均无统计学意义（P〉0.05）;对照组与TN组中B组（轻度压迫组）、C（重度压迫组）、D组（受压变形并萎缩）3组比较,ADC、FA值差异均存在统计学意义（P均〈0.05）;压迫部位ADC值增高28例,不变4例,平均ADC值明显高于对照组（P〈0.05）;压迫部位FA值下降15例.不变11例,增高5例,平均FA值明显低于对照组（P〈0.05）. 结论 DTI对判断血管压迫三叉神经有一定价值,三叉神经压迫程度越大,ADC值越高,FA值越低.

Objective To study the vascular compression on the ponline cistern of the trigeminal with magnetic resonance diffusion tensor imaging （DTI） and explore the clinical application value of DTI.Methods Sixty patients who were conformed by operation as having trigeminal neuralgia （TN） caused by responsible vascular compression （TN group） and 50 healthy volunteers （control group） were performed conventional MRI and horizontal DTI to measure the apparent diffusion coefficient （ADC）value and fractional anisotropy （FA） value. Results The ADC value and FA value of trigeminal nerve in control group were （1.76±0.98）×10-3 mm2/s, and （0.40±18）, respectively, no significant differences of the ADC value and FA value between the left and right trigeminal nerves were found （P〉0.05）. The ADC and FA values of the trigeminal nerve among the controls, patients with mild or severe compression and the patients with compression combined with neuratrophia were statistically difrerent（P〈0.05）. The ADC value in the oppression region was increased in 28 patients and unchanged in 4; the average ADC value in the NT group was significantly higher than that in the control group. FA value in the oppression region decreased in 15 patients, unchanged in11 and increased in 5; the average FA value in the NT group was lower than that in the control group. Conclusion DTI has its value in determining the vascular compression of the trigeminal nerve; the greater the degree of trigeminal nerve compression is, the higher the ADC value and the lower the FA value are.