64排螺旋CT辅助立体定向穿刺治疗三叉神经痛

64-slice spiral CT assisted stereotactic puncture in treatment of trigeminal neuralgia

目的:探讨64排螺旋CT辅助立体定向技术在三叉神经半月结穿刺中的应用价值。方法:该组病例的穿刺均是利用立体定向技术完成三叉神经半月结穿刺,与传统立体定向框架安装方法不同,笔者采用反装框架,开始8例在CT机直接测定靶点三维坐标值,后来19例在螺旋CT机上既测定靶点坐标同时行模拟穿刺以调整确定穿刺点坐标。结果:利用上述方法完成27例共28侧三叉神经半月结穿刺,穿刺一次成功率100%,有2例患者在术前即修正穿刺途径,避免了骨质阻挡,无严重并发症,随访1年无复发病例。结论:64排螺旋CT辅助立体定向穿刺三叉神经准确、安全。

Objective：To study the value of Light Speed VCT assisted stereotactic in the puncture of trigeminal ganglion.Methods：All of the punctures were executed by applicating stereotactic through mounting the frame reversed.8 cases of three-dimensional coordinate of target were measured directely in the CT machine,19 cases of three-dimensional coordinate of target and percutaneous point were determined by simulating the pathway of puncture in the spiral CT.Results：All the punctures of trigeminal ganglion had been settled successfully in one time without any severe complication,especially included 2 cases which were kept away from the obstacle of bone by modifing the pathway preoperativly,and founded no recurrence in all trigeminal neuralgias at 1-year follow-up.Conclusion：Light Speed VCT assisted stereotactic puncture in treatment of trigeminal neuralgia was accurate,safe and reflected the perfect combination of modern high-tech and clinical medicine.