3D-FIESTA及MRVE成像技术对Ⅸ、Ⅹ脑神经与神经源性高血压的病因初探

A preliminary study on the relationship between Ⅸ、Ⅹ cranial nerves and neurogenic hypertension by3D-FIESTA and MRVE imaging technology

目的利用MR新技术探讨部分原发性高血压患者延髓的血管与神经解剖比邻的空间关系。方法应用高分辨3D-FIESTA及MRVE成像技术对临床拟诊断神经源性高血压患者和正常对照组检查。结果脑神经进入脑干区延髓腹外侧血管压迫或接触占59.38%(19例),其中V 2例、Ⅸ和X17例,未见明显血管压迫及接触的占40.62%(13例)。其中血管与脑干不相交未接触占21.86%(7例);血管与脑干相交未接触例占18.75%(6例);血管与脑干轻微接触占28.13%(9例);血管与脑干接触并压迫脑干移位变形占31.25%(10例)。与神经接触主要是小脑下后动脉与椎动脉,分别占52.6%(10例)与36.8%(7例);小脑下前动脉仅占10.5%(2例)。结论 MR 3D-FIESTA成像及MRVE后处理技术能显示原发性高血压患者延髓的神经血管关系,对部分原发性高血压明确病因和指导治疗有一定意义。

Objective We investigated the anatomical spatial relations between vessels and nerves around the medulla oblongata in patients with primary medullary hypertension by MR new techniques. Methods Patients with diagnosis of neurogenic hypertension and patients in the control group underwent high resolution 3D-FIESTA and MRVE imaging. Results The cranial nerves were vascularly compressed and in contact with the vessels on the ventrolateral aspect of medulla oblongata in 19 cases, accounting for 59.38%, including 2 cases of V, 17 cases of IX and X. 13 cases had no obvious vascular compression and contact. The blood vessels and brain stem did not contact or intersect in 7 cases （21.86%）; and the brain stem and vessels intersect but not in contact in 6 cases （18.75%）; brain stem and vessels contact in a small area （28.13%）; and the brain stem and vessels contacted and the brain stems were displaced in 10 cases （31.25%）. The vessels that were in contact with the nerves included the posterior inferior cerebellar artery in l0 cases and the vertebral artery in 6 cases. The anterior inferior cerebellar artery accounted for only 10.5%. Conclusions MR 3D-FIESTA imaging and MRVE post-processing techniques can display the medulla oblongata neurovascular relationships of primary hypertension patients, and has a certain significance for investigation of the etiology of primary hypertension and for treatment guidance.