DTI技术在微血管减压术治疗三叉神经痛中的应用价值

Practical significance of DTI technique on microvascular decompression for trigeminal neuralgia

目的探讨DTI技术在微血管减压术治疗三叉神经痛中的应用价值。方法采用3.0 T MRI对22例三叉神经痛患者行3D-TOF序列和DTI成像,测量其患侧与健侧部分各向异性分数(FA)值、表观扩散系数(ADC)值。对两侧的参数值进行统计学分析。结果患侧三叉神经的FA值(0.23±0.08)显著低于健侧(0.47±0.09)(P<0.05);患侧三叉神经的ADC值[(2.98±0.45)×10-3mm2/s]明显高于健侧[(1.39±0.35)×10-3mm2/s](P<0.05)。微血管减压手术前患侧三叉神经的FA值、ADC值与术后的FA值(0.53±0.13)、ADC值[(1.40±0.39)×10-3mm2/s]比较,差异有统计学意义(均P<0.05)。微血管减压手术后患侧三叉神经的FA值、ADC值和健侧比较,差异无统计学意义(均P>0.05)。结论 DTI对判断血管压迫导致的三叉神经痛的影像学诊断和微血管减压术后疗效影像学评估有一定的临床参考价值。患侧三叉神经受压迫程度越大,ADC值越高,FA值越低。

Objective To detect the practical significance of DTI technique on microvascular decompression for trigeminal neuralgia. Methods Twenty-two patients with trigeminal neuralgia underwent 3. 0 T MRI scanning with3D-TOF sequence and DTI technique. The fraction of anisotropy（ FA） and the apparent diffusion coefficient（ ADC）of trigeminal nerves at affected side and healthy side were measured. The data between the two sides were compared.Results The FA of the trigeminal nerves at affected side（ 0. 23 ± 0. 08） was significantly lower than that at healthy side（ 0. 47 ± 0. 09）（ P 0. 05）. The ADC of the trigeminal nerves at affected side [（ 2. 98 ± 0. 45） × 10- 3mm2/ s]was significantly higher than that at healthy side [（ 1. 39 ± 0. 35） × 10- 3mm2/ s]（ P 0. 05）. The preoperative FA and ADC of the trigeminal nerves at affected side were significantly different with the postoperative FA（ 0. 53 ± 0. 13）and ADC [（ 1. 40 ± 0. 39） × 10- 3mm2/ s]（ all P 0. 05）. There was no statistical significant difference of FA and ADC between postoperative affected side and healthy side（ all P 0. 05）. Conclusions DTI has certain clinical significance on imaging diagnosing trigeminal neuralgia caused by vascular compression and radiographic assessing curative effect of microvascular decompression. The degree of compression at affected side greater,the ADC is higher and the FA is lower.