血管压迫性三叉神经痛责任血管形态与分布的MRI表现

Morphologic characteristics and sites of offending blood vessels of vascular compression trigeminal neuralgia in MRI

目的探讨血管压迫性三叉神经痛患者责任血管形态学表现与分布区域。方法回顾分析19例血管压迫性三叉神经痛患者磁共振血管断层成像检查,并与手术结果对照,明确三叉神经血管压迫症状患者责任血管形态学表现及分布区域。结果 19例中共有17支责任动脉血管与8支责任静脉血管,13支(13/17,76.47﹪)责任动脉血管均较健侧迂曲、冗长,8支责任静脉血管与基底动脉的距离短于健侧。位于三叉神经出脑干段背侧至内侧区域的责任动静脉血管共有14支,其中以小脑上动脉居多,有12支(12/14,85.71﹪);位于三叉神经根部腹侧至外部区域的责任动静脉血管共有11支,其中以岩静脉及其属支居多,有7支(7/11,63.64﹪)。结论责任动静脉血管形态上具备区别于健侧血管的特征性表现,动脉与静脉责任血管在空间分布上具有明显的差异,血管形态与分布区域可作为判断责任血管的间接征象。

Objective To investigate the morphologic characteristics and sites of offending blood vessels of vascular compression trigeminal neuralgia in MRI. Methods High resolution magnetic resonance tomographic angiography （MRTA） of 19 patients with trigeminal neuralgia were retrospectively analyzed. The MRI findings were compared with results of the surgeries. The morphologic characteristics and sites of blood vessels in MRI were analyzed. Results Among 19 patients, there were 17 the offending arteries and 8 offending veins. 13 of offending arteries were circuity, longer than that of the normal side （13/17, 76.47 % ）, all of 8 offending veins were at a shorter distance of from the basilar artery than that at the normal side. 14 offending vessels located in the dorsal and interior zone of root entry zones of trigeminal nerve, most of them （ 12 ） were superior cerebellar arteries （SCA） （12/14, 85.71% ） ; 11 offending vessels located in the ventral and exterior zone of root entry zones of trigeminal nerve, most （7） were petrosal veins （PV） or its branches （7/11, 63.64% ）. Conclusion offending arteriovenous vascular morphology had several features that are different from the normal vessels. Arterial and venous offending vessels in the spatial distribution have obvious differences. Vascular morphology, and cite can be used as an indirect sign of offending blood vessels.