磁共振B-FFE序列定位伽玛刀治疗原发性三叉神经痛的疗效观察

The efficiency of gamma knife localized by Balance-Fast Field Echo sequence in patients with primary trigeminal neuralgia

目的探讨磁共振成像（magnetic resonance imaging,MRI）平衡式快速梯度回波（Balance-FastField Echo,B-FFE）序列定位,伽玛刀治疗原发性三叉神经痛的疗效。方法 81例原发性三叉神经痛患者,采用磁共振B-FFE序列定位伽玛刀治疗。安装定位框架时,头架基础环平行于听眦线向前上开放15°夹角所形成的直线,以此为扫描基准线。进行定位规划时,靶点定在三叉神经根部,4 mm准直器,中心剂量80-85 Gy。结果所有患者随访12-18个月,治疗有效率96.3%,治愈率81.5%,并发症发生率2.5%。所有患者无放射性脑水肿、脑干损伤等严重并发症。结论采用磁共振B-FFE序列定位能清晰地显示三叉神经根,有利于伽玛刀治疗的准确定位,能提高治愈率和有效率,可以作为伽玛刀治疗原发性三叉神经痛的常规定位方法加以推广应用。

Objective To discuss the efficiency of gamma knife localized by Balance-Fast Field Echo（B-FFE） sequence in patients with primary trigeminal neuralgia（TN）.Methods Eighty-one patients with TN were treated by gamma knife with B-FFE sequence localization.While setting the stereotactic frame,the frame was in parallel with the line which had a 15-degree angle with the OM line and which also was the scanning baseline.And we radiated the root entry zone（REZ） of trigeminal nerve with the mean central dose of 80~85 Gy and one 4 mm collimator.Results All the patients were followed up for 12~18 months.The efficiency of the treatment was 96.3%,the cure rate was 81.5%,and the complication rate was 2.5%.There was no significant complication as radiation-induced brain injury and brain-stem injury.Conclusion The REZs of trigeminal nerve of patients with B-FFE sequence localization are legible in their MRI.It is of great benefit to the gamma knife treatment of the patients,and it could raise the cure rate and the efficiency.B-FFE sequence localization can be used as a conventional localization method for gamma knife radiosurgery in the treatment of trigeminal neuralgia.