3D-TOF-SPGR对面肌痉挛微血管减压术前诊断价值

THE VALUE OF 3D-TOF-SPGR FOR PREOPERATIVE DIAGNOSIS OF MICROVASCULAR DECOMPRESSION FOR HEMIFACIAL SPASM

目的探讨三维时间飞跃扰相稳态梯度回波(3D-TOF-SPGR)序列在面肌痉挛微血管减压术前诊断中的应用价值。方法由两名有经验的神经放射科医师,采用盲法分析32例临床诊断为原发性面肌痉挛病人的3D-TOF-SPGR序列图像,并与开颅应用微血管减压术术中结果比较。结果 32例原发性面肌痉挛病人术前3D-TOF-SPGR序列图像显示血管神经压迫症状侧阳性率为84.4%,非症状侧阳性率为6.3%,差异有显著性(P=0.000)。与术中结果比较,其诊断的灵敏度为87.10%,特异度为100%,约登指数为0.87,一致率为87.5%,阳性预测值为100%,阴性预测值为20%。结论 3D-TOF-SPGR序列成像是原发性面肌痉挛的术前影像学诊断的有效手段。

Objective To assess the value of 3D-TOF-SPGR sequence in preoperative diagnosis for microvascular decom- pression in the treatment of hemifacial spasm （HS）. Methods A single blind analysis was carried out by two experienced neuro radiologists for 3D-TOF-SPGR sequence maps of 32 patients with primary HS-who were diagnosed clinically. The findings were compared with the results observed at craniotomy microvascular decompression. Results The preoperative 3D-TOF-SPGR se- quence image displayed that the positive rate of vascular-nerve-oppressed side was 84.4%, and that of non-symptom side was 6.3 %, the difference being significant （P 〈0.000）. Compare with intraoperative results, the diagnostic sensitivity was 87.10 %, specificity was 100%, Youden index was 0.87, the concordance rate was 87.5%, the positive and negative predictive values were 100% and 20%, respectively. Conclusion 3D-TOF-SPGR sequence is an effective method for preoperative imaging diagnosis of primary hemifacial spasm.