MRTA对三叉神经痛患者微血管减压术后疗效的预测

Predicting the outcome of microvascular decompression for patients with trigeminal neuralgia by the use of MRTA

目的:评价磁共振体层血管成像(MRTA)对预测三叉神经痛患者微血管减压术(MVD)后疗效的价值。方法 :277例行MVD的三叉神经痛患者手术前、后接受MRTA检查,由2名影像医师分别读取术前及术后NVC分级,术后疗效分为优、良和差3组,采用SPSS 13.0软件包中的χ2检验确定术前NVC的压迫程度、术后NVC压迫程度和术后NVC的缓解度在3组的分布有无差异。结果:250例(90.2%)病例术后2年疗效为优,18例(6.5%)为良,8例(2.9%)为差,1例(0.4%)因术后颅内出血死亡。术前不同NVC分级的病例,术后疗效无显著差异(χ2=5.542,P=0.476);术后不同NVC分级(χ2=18.693,P<0.05)和不同NVC缓解度(χ2=11.484,P<0.05)的病例,术后疗效有显著差异。结论:MVD术后行MRTA检查,是预测术后疗效较为有效的方法之一,术后NVC分级越大和NVC缓解度越小的病例,MVD术后疼痛缓解不佳的可能性越高。

PURPOSE：To determine the value of magnetic resonance tomographic angiography （MRTA） in predicting the outcome of microvascular decompression（MVD） for patients with trigeminal neuralgia. METHODS ： Two hundred seventy- seven cases of trigeminal neuralgias （TNs） who underwent MVD underwent MRTA preoperatively and postoperatively. The images were independently reviewed by two radiologists. All the cases were divided into 3 groups （excellent, good, poor） according to the outcome of 2 years follow-up. The relationship between the severity of preoperative NVC, the severity of postoperative NVC, the relief of NVC and the outcome after MVD was analyzed by χ2test using SPSS 13.0 software package. RESULTS：Two years after MVD, 250 cases （90.2%）,18 cases （6.5%） and 8 cases （2.9%） achieved excellent, good and poor outcome. One patient （0.4%） died of intracranial hemorrhage. A significant difference was found between the severity of postoperative NVC（χ2=18.693 ,P〈0.05）, the relief of NVC（χ2=11.484,P〈0.05） and the outcome after MVD. However, no significant correlation was found between the severity of preoperative NVC and the outcome （χ2=5.542,P= 0.476）. CONCLUSION： Postoperative MRTA examination is one of the effective methods for predicting the outcome of MVD, the incident of worse results is higher in patients with more severe postoperative NVC and little relief NVC.