3D FIESTA联合3D TOF MRA对三叉神经血管压迫的诊断价值

Diagnostic value of MRI 3D FIESTA combined with 3D TOF MRA sequence in evaluation of the trigeminal neurovascular compression

目的 :探讨MRI 3D循环相位稳态采集快速成像(FIESTA)序列联合3D TOF MRA序列对三叉神经血管压迫的诊断价值。方法:选取以原发性三叉神经痛就诊的患者25例,均行3D FIESTA和3D TOF MRA。由2名有经验的影像诊断医师在不知道临床症状的情况下对图像进行观察,分析2种序列中三叉神经和邻近血管的走行关系,以评价2种序列联合显示神经血管压迫与临床症状的相关性。结果:20例行手术治疗,与手术结果对照,MRI对血管压迫诊断的阳性符合率为78.9%(15/19),另4例为假阳性(21.1%,4/19);1例术前MRI诊断未见明确神经血管压迫者术中得到证实。5例术前MRI诊断无神经血管压迫的患者未行手术治疗。结论:MRI 3D FIESTA联合3D TOF MRA可清晰显示三叉神经的血管压迫情况,且与临床症状具较好相关性,可帮助临床医师进行术前评估。

Objective：To investigate the value of MRI 3D fast imaging employing steady-state （3D FIESTA） sequence combined with 3D time of flight magnetic resonance angiography （3D TOF MRA） in diagnosis of trigeminal neurovascular compression. Methods：25 cases of primary trigeminal neuralgia patients were examined by MRI （including 3D FIESTA and 3D TOF MRA）. The images were reviewed by two experienced radiologists. The spatial relationships between the trigeminal nerve and adjacent vessels were overviewed,in order to evaluate the relevance between neurovascular compression and clinical symptoms. Results：20 cases were received microvacular decompression surgery. The presence of vascular compression were confirmed in 15 cases , with the positive coincidence rate of 78.9% （15/19）,another 4 cases of false positive （21.1%,4/19）. While the remain 1 case with diagnosis of no neurovascular compression was proved by surgery. 5 cases with preoperative MRI diagnosis of no neu-rovascular compression did not receive operation treatment. Conclusions：The trigeminal neurovascular compression can be dis-played clearly by MRI 3D-FIESTA combined with 3D-TOF-MRA,and also has a good correlation with clinical symptoms. This can help clinicians to make decision preoperatively.