联合应用磁共振3D-FIESTA和3D-TOF序列对血管压迫性三叉神经痛的诊断价值

Value of combination of 3D-FIESTA and 3D-TOF sequences in diagnosing vascular compressive trigeminal neuralgia

目的评价磁共振3D-FIESTA联合3D-TOF序列对血管压迫性三叉神经痛的诊断价值。方法收集53例原发性单侧三叉神经痛患者的临床及MRI检查资料,由两位经验丰富的影像科医生对3D-FIESTA与3D-TOF序列原始和重组图像进行诊断分析,判断三叉神经桥前池段和邻近血管的关系,并与临床症状进行对照比较。结果所有病例中检出三叉神经桥前池段与邻近血管间存在接触或压迫关系的共有40侧,其中症状侧38例,非症状侧2例;神经血管间存在可能接触的有17侧,其中症状侧11例,非症状侧6例;神经血管无接触的有49侧,其中症状侧4例,非症状侧45例。联合应用3D-FIESTA和3D-TOF序列诊断三叉神经与邻近血管的关系,症状侧与非症状侧检查结果之间存在显著差异。结论联合应用磁共振3D-FIESTA和3D-TOF序列有利于提高血管压迫性三叉神经痛责任血管的检出率,可以为原发性三叉神经痛的病因诊断、治疗方案制定及预后评估提供有价值的影像学参考。

Objective To evaluate the value of 3D-FIESTA sequence combined with 3D- TOF sequence in diagnosing vascular compressive trigeminal neuralgia. Methods Clinical and MRI materials of 53 patients with primary unilateral trigeminal neuralgia were collected. The original and recombinant images of 3D-FIESTA and 3D-TOF sequences were diagnosed and analyzed by two experienced radiologists. Relationship between pontine cistern section of trigeminal nerve and adjacent vessels were judged and compared with clinical symptoms. Results Among all the patients, contact or oppressive relationship between pontine cistern section of trigeminal nerve and adjacent vessels was detected in 40 cases, including 38 cases of symptomatic side and 2 cases of non -symptomatic side. Possible contact between nerve and vessel was detected in 17 cases, including 11 cases of symptomatic side and 6 cases of non-symptomatic side. Contact between nerve and ves- sel was not detected in 49 cases, including 4 cases of symptomatic side and 45 cases of non-symp- tomatic side. Based on the results of relationships between nerve and vessel by detection of 3D-FI- ESTA sequence combined with 3D-TOF sequence, there were significant differences of diagnostic results of symptomatic side and non-symptomatic side. Conclusion Combination of 3D-FIESTA and 3D-TOF sequences are helpful to improvement of the detection rate of responsibility vessel of vascular compressive trigeminal neuralgia, and it can provide valuable imaging references for the etiological diagnosis, therapeutic plan establishment and prognosis evaluation in patients with primary trigeminal neuralgia.