CT与MRI导航下半月神经节射频术中的比较研究

Comparative study of radiofrequency thermocoagulation of gasserian ganglion by CT and MRI guided neuronavigation

目的探讨以CT或MRI影像为导向在神经导航下半月神经节射频术中治疗三又神经痛的疗效和安全性。方法原发性三叉神经痛256例，随机分为CT组（C组）和MRI组（M组）各128例，分别利用导航系统进行穿刺和半月神经节射频。比较两组穿刺成功率和相关并发症发生率，记录术后1、7d、1、6、12、24个月视觉模拟评分（VAS评分），并根据巴罗神经学研究所（BNl）评分系统评估镇痛效果。结果两组穿刺的成功率和穿刺过程中的并发症发生率比较差异无统计学意义（P〉0．05）；c组射频并发症高于M组（P〈0．05），且两组术后12个月和24个月的有效率比较差异有统计学意义（P〈0．05）。结论MRI影像导航下半月神经节射频术治疗三叉神经痛具有并发症少、靶点选择性高和疼痛复发率低等优势，且无x线辐射损伤。

Objective To investigate the efficacy and safety of the treatment of primary trigeminal neuralgia using percutaneous radio -requency thermocoagulation of the Gasserian ganglion by CT and MRI - guided neuronavigation. Methods 256 cases of primary trigeminal neuralgia were randomly divided into CT group （group C） and MRI group （group M） with 128 cases respectively. Radio -requency thermocoagulation of the Gasserian ganglion was performed after neuronavigational puncture in the two groups separately. The puncturing success rate and the complications rate between two groups were recorded. The VAS was scored respectively by 1 day, 7 days, 1 month, 6 months, 12 months, and 24 months postoperatively. The outcome responses of pain relief were evaluated using visual analog scale （VAS） and the Barrow Neurological Institute （BNI） scoring systen. Results The success rate of puncture and complications in puncturing showed no statistical significance （ P 〉 0. 05 ）, but the complication rate of Radio - requency in group C was higher then group M（ P 〈 0. 05 ）, and the treatment effect of group M is better then group C at 12 months and 24 months （ P 〈 0. 05）. Conclusions The radio - requency thermocoagulation of the Gasserian ganglion by MRI -guided ueuronavigation owe more advantages including a lower complications rates, a high selectivity of target, Rower recurrence rate and no radiation injuries by X -ray.