3.0T MR 3D-COSMIC序列结合多平面重建对12对脑神经脑池段的成像价值

Imaging the cisternal segment of cranial nerves with 3.0T MR 3D-COSMIC and multiplanar reconstruction

目的探讨3.0T MR 3D-COSMIC成像序列对Ⅰ～Ⅻ对脑神经脑池段显示的临床价值。方法采用3.0T MR扫描仪对20例健康志愿者和10例疑因血管等原因压迫相应颅脑神经产生临床症状的患者进行MR检查,扫描序列包括3D-COS-MIC及3D-TOF-SPGR。并由2名神经放射学医师根据20例健康志愿者480支颅神经显示的清晰程度分为清晰、较清晰、不清晰3个等级,清晰和较清晰定义为显示,不清晰定义为未显示,而神经与血管的关系分为无接触、接触、压迫。结果脑神经在3D-COSMIC序列的显示率分别为:嗅神经(86%),视神经(100%),动眼神经(97%),滑车神经(23%),三叉神经(100%),外展神经(90%),面神经(100%),前庭蜗神经(100%),后组颅神经复合体[舌咽神经(63%)、迷走神经(100%)、副神经(53%)、舌下神经(40%)]。10例神经症状患者3例显示神经与周围血管接触或压迫,且均为神经外科手术证实。结论 3D-COSMIC成像序列可以较为清晰显示除滑车神经之外12对脑神经脑池段形态、走行及其与血管的关系,尤其能很好显示Ⅱ、Ⅲ、Ⅴ、Ⅵ、Ⅶ、Ⅷ、Ⅹ共7对脑神经脑池段,为临床诊治提供更大的指导作用。

Objective To investigate the applying value of 3D-COSMIC MRI sequences for cranial nerves Ⅰ-Ⅻ. Methods 3D- COSMIC were used in 20 volunteers and 10 patients with complaint of cranial nerves. 480 nerves were evaluated. Two radiologists independently divided the imaging findings into 3 grades.. 1 （completely visualized）, 2 （partially visualized）, and 3 （ not visualized）. The first two grades were defined as visualization and the last grade was no visualization, the relationship between nerves and sur rounding vessels were divided into grades： 1 （notcontact）, 2 （contact）, 3 （compression）. Results The rate of visualization of these cranial nerves with 3D-COSMIC sequences were as follows respectively： nerve I （86 % ） ; nerve Ⅱ （ 100 % ） ; nerve Ⅲ （97 % ） ; nerve Ⅳ（23%）;nerve V （100%）;nerve Ⅵ（90%）;nerve Ⅷ（100%）;nerve %%（100%）;nerve Ⅸ-Ⅺ complex（63%,100% and 53%）; nerve % （40 % ）. 3 of 10 patients with complaint of cranial nerves displayed nerve had vascular compression or contact. Conclusion 3D-COSMIC sequence can show detailed anatomy of the cranial nerves and relationship between nerves and surrounding vessels, es- pecially Ⅱ , Ⅲ , Ⅴ , Ⅵ, Ⅶ, Ⅷ, Ⅹ cranial nerves,to help clinical treatment.