磁共振仿真内窥镜技术在前庭蜗神经微血管压迫综合征中的应用价值

Value of MR virtual endoscopy to diagnosis and treatment of vestibulocochlear nerve compression syndrome

目的探讨磁共振仿真内窥镜技术(MRVE)在前庭蜗神经微血管压迫综合征中的应用价值。方法回顾性分析2011年2月至2012年10月行MRI检查的397例患者的影像学资料,利用MRVE显示前庭蜗神经和周围微血管关系,结合多平面重建技术(MPR)进行综合分析。结果 MPR显示,有微血管存在但无神经压迫的41例中,MRVE显示6例为可疑压迫,35例无压迫;MPR显示存在神经压迫或接触241例,与MRVE显示的一致;MPR显示的可疑神经压迫或接触135例中,MRVE显示99例存在压迫或接触,36例可疑有压迫。MRVE与MPR诊断一致的312例,符合率78.59%。但MRVE可对神经微血管进行三维立体显示。结论 MRVE作为一种无创的成像方式,可直观的显示前庭蜗神经和周围微血管的关系以及血管走形方式,为临床术前评估和术中指导提供重要的影像学依据。但在显示前庭蜗神经和微血管间距上存在一定的不足,需结合MPR进行综合分析。

Objective To explore the value of MR virtual endoscopy （MRVE） to the diagnosis and treatment of the vestibulocochlear nerve compression syndrome. Methods MRVE was performed in order to show the relationship between the vestibulocochlear nerves and blood vessels around the vesibulocochlear nerves in 397 patients with vestibulocoehlear nerve compression syndrome who also be examinated by 3D-SPACE sequence in order to obtain the multi-planar reconstruction （MPR） imagings. All the imaging data were Analyzed and compared in order to find out the advantages of MRVE. Results MRVE showed that of 41 patients without nerve compression shown by MPR, 6 had suspeetable nerve compression and 35 not. Both the MRVE and MPR showed that 241 patients had nerve compression. MRVE showed that of 135 patients with suspected nerve compression shown by MPR, 36 had suspected nerve compression and 99 had nerve compression. The diagnosis made by MRYE accorded with that made by MPR in 312 patients （78.59%） and three-dimensional images of the nerves and blood vessels were shown by MRVE. Conclusions The MRVE, which is a noninvasive imaging method, can objectively show the relationship between the vestibulocoehlear nerves and microvessels around them and microvascular run, and may provide an important basis for the clinical preoperative assessment and intraoperative treatment of vestibulocochlear nerve compression syndrome. But there are some deficiencies in displaying the distances between the vestibulocochlear＇nerves and microvessels around them, which need to be comprehensively assessed by MRVE combined with MPR.