磁共振成像在三叉神经痛和面肌痉挛诊断中的应用

The role of MRI in diagnoses of trigeminal neuralgia and facial spasm

目的 对应用磁共振成像（ＭＲＩ）特殊序列诊断三叉神经痛（ＴＮ） 和面肌痉挛（ＦＳ）血管神经压迫的价值进行评价。方法 临床诊断ＴＮ１８ 例，ＦＳ１１ 例。先行ＳＥＴ１ＷＩ、Ｔ２ＷＩ扫描，然后行三维时间飞越破坏性稳态梯度回波序列（３ＤＴＯＦＳＰＧＲ） 分析。利用原始图像对两侧三叉神经进行斜矢状位和冠状位重建。结果 ＴＮ中，２ 例为肿瘤所致，１５ 例为血管压迫引起，１ 例未发现病因。１１ 例ＦＳ中发现血管神经接触１０ 例，未发现病因１ 例。８ 例手术证实病例中，７ 例与ＭＲＩ诊断完全符合。结论ＭＲＩ对发现ＴＮ和ＦＳ病因具有重要价值，特别是３ＤＴＯＦＳＰＧＲ原始图像是显示神经血管接触的敏感方法，对选择手术方法具有重要的指导意义。

Objective To evaluate the diagnostic value of MRI for neurovascular compression (NVC) in TN and FS. Methods 18 patients with TN and 11 patients with FS underwent SE T 1WI and T 2WI first, then 3D TOF SPGR sequences. After the two dimensional transaxial images were made, oblique sagittal and coronal planar reformation for trigeminal nerves were made. Surgical operations were performed in 8 patients. Results In the TN group, there was one tumor found in each of the 2 cases, NVC was found in 15 cases and neither tumor nor NVC was found in 1 case. In the FS group, NVC was found in 10 cases, but there was no definite cause in 1 case. MRI findings were consistent with the surgical operative findings completely except in one case. Conclusion It is considered to be of important value to use MRI to find out the causes of TN and FS, especially to utilize the 3D TOF SPGR sequence which may possess high sensitivity in determining NVC. This may be of help in selecting the proper method of treatment for the patients with TN or FS.