磁共振DTI序列检测MVD对三叉神经微结构的影响

Diffusion tensor imaging detects trigeminal nerve microstructure changes after MVD in trigeminal neuralgia patients

目的利用磁共振扩散张量成像(DTI)序列,探讨微血管减压术(MVD)术对三叉神经微结构的影响。方法分析17例三叉神经痛患者双侧三叉神经各向异性值(FA)值在术前、术后短期(1 w)及术后长期(6个月)的变化并与对照组进行比较研究。结果患者组术前三叉神经FA值患侧较健侧下降约7%(P=0.001);术后1 w患侧FA值稍有上升,双侧差异缩小为3%(P=0.081);术后6个月患侧与健侧已无明显差异(P=0.493)。对照组双侧FA值无差异(P=0.609)。结论DTI序列从影像学上证实MVD术可通过恢复病变三叉神经纤维的正常走行及髓鞘再生两个方面起作用。

Objective To study the effect of microvascular decompression （MVD） on trigeminal neuralgia through an ultrastructural analysis by using diffusion tensor imaging （DTI）. Methods A comparative analysis was performed in 17 cases of idiopathic trigerrfinal neuralgia, who underwent MVD and completed the fellow-up （ 1 week and 6 months after operation） and 17 controls. Results Before operation, the fractional anisotropy （FA） values in affected sides were significantly decreased by 7% compared with the unaffected sides. One week after MVD, FA values in affected sides were slightly increased. Differences between both sides were not significant. Six months after operation, there were no differences between both sides as well as controls. Conclusion DTI method may reflect the effect of MVD on restoration of trigeminal nerve microstructure, including recovery of the direction and remyelination of demyelinated axon.