原发性三叉神经痛中神经血管关系的MR应用研究

The MR Applications of Displaying the Relationship Between the Nerve and Vessels in Trigeminal Neuralgia

目的:探讨磁共振3D-FIESTA(三维快速平衡稳态进动)序列、3D-TOF-MRA序列对显示原发性三叉神经痛(primary trigeminal neuralgia,PTN)患者神经血管关系的应用价值。方法:回顾性分析2010年6月-2012年2月共29例临床诊断原发性三叉神经痛患者3D-FIESTA序列及3D-TOF-MRA序列图像中神经血管关系,其中10例对照手术。结果:29例双侧三叉神经显示率100%;3D-FIESTA、3D-TOF-MRA序列显示患侧与神经紧密相临血管阳性率分别为86.2%、82.8%,二者差异无统计学意义(P>0.1);二序列同时应用阳性率93%(27/29),高于单用一序列,但无统计学意义(P>0.1)。结论:MRI能为三叉神经痛病因分析和治疗方案的制定提供信息,3D-FIESTA序列及3D-TOF-MRA序列显示神经血管关系价值相当,二者同时应用可以提高神经周围血管显示阳性率,并能更为明确地显示局部细节。

Objective：To discuss the applied value of three dimensional time-of-flight magnetic resonance angiography （3D-TOF-MRA） and three- dimensional fast imaging employing steady- state acquisition（3D-FIESTA）used displaying the relationship between the nerve and vessels in Trigeminal Neuralgis. Methods：Retrospective analysed 29 MR images of PTN patients including 3D-FIESTA and 3D-TOF-MRA from June 2010 to February 2012,10 cases compared sur- gery. Results： The positive rate of displaying bilateral trigeminus was 100%, the positive rate of displaying vessels tight- ening contacting trigeminus were 86. 2% with 3D-FIESTA and 82. 8% with 3D-TOF-MRA, there were no significant difference （P〉0. 1）. The positive rate combining 2 sequences was 93%, exceeding each, but no statistically significant （P〉0. 1）. Conclusion： MRI could provide information for therapeutic schedule and etiological factors of trigeminal neu-ralgia. And 3D-FIESTA corresponded to 3D-TOF-MRA. Combining two could enhance the positive rate and showed more explicit local details.