3TMR体层血管造影对血管压迫性三叉神经痛的诊断价值

Value of Magnetic Resonance Tomographic Angiography in Diagnosis of Trigeminal Neuralgia at 3T MRI

目的:探讨3T磁共振体层血管造影(MRTA)对血管压迫性三叉神经痛的诊断价值。方法:回顾性分析60例手术治疗的血管压迫性三叉神经痛患者的MRTA表现,评判三叉神经周围有无血管压迫,并与术中观察结果对照。结果:症状侧血管压迫者52例,非症状侧血管压迫5例,两者差异有统计学意义(P<0.01)。MRTA显示的神经血管接触52例中,术中49例发现有血管压迫或接触,MRTA显示无接触的8例中有4例发现血管压迫或接触。以手术结果为金标准,MRTA判断血管压迫性三叉神经痛的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为92.5%、57.1%、88.3%、94.2%和50%。结论:MRTA可以准确显示三叉神经根与周围血管的关系,为血管压迫性三叉神经痛的诊断及治疗提供可靠的影像学依据。

Purpose： To evaluate the value of magnetic resonance tomographic angiography （MRTA） in display of neurovascular compression in patients with trigeminal neuralgia（TN） at 3T MRI. Methods： MRTA findings and operative results of 60 patients with TN were reviewed retrospectively. The of- fending vessels surrounding trigeminal nerve were evaluated and correlated with the operation findings. Results： MRTA showed vessel - nerve contact in 52 cases on the symptomatic sides and 5 cases on the asymptomatic sides. The difference was statistically significant, P 〈 0.01. Of the 52 cases with vessel - nerve contact shown on MRTA, 49 were shown vascular contact or compression by operation. The sen- sitivity, specificity, accuracy, positive predictive value and negative predictive value of the diagnosis of vascular - nerve compression by MRTA was 92.5%, 57.1%, 88.3%, 94.2%, 50%, respectively. Conclu- sion： MRTA could perfectly display the offending vessels of vascular compressive TN and provide cred- ible imaging evidence for pathogenic diagnosis and clinical treatment planning.