3D-FIESTA和3D-TOF-MRA扫描对面肌痉挛的术前评估价值

Effectiveness of Application of 3D-FIESTA and 3D-TOF-MRA in PreOperative Assessment of Hemi-Facial Spasm

目的：探讨磁共振三维稳态进动快速成像序列（3D-FIESTA）和三维时间飞跃法磁共振血管成像（3D-TOF-MRA）扫描对面肌痉挛的术前评估价值。方法选取2014年1月~2015年4月我院收治的69例面肌痉挛患者，所有患者均在微血管减压术前进行3D-FIESTA和3D-TOF-MRA扫描。以手术结果为金标准，分析磁共振断层图像对面肌痉挛责任血管术前评估的准确性。结果症状侧神经受血管压迫比例为88.4%（61/69），高于非症状侧神经受血管压迫比例4.3%（3/69），责任血管的压迫与临床症状有密切关系。以手术结果作为判断责任血管的金标准，磁共振成像（MRI）发现责任血管的敏感度为88.4%（61/69），准确度100%（61/61），两种序列联合使用其图像质量优于单独使用3D-FIESTA和3D-TOF-MRA（P值分别为0.021和0.063）。结论磁共振断层图像可以敏感、准确地显示血管与面神经的关系，有助于术前判定面肌痉挛的责任血管。

Objective To investigate the effectiveness of application of 3D-FIESTA （Three Dimensional Fast Imaging Employing Steady-State Acquisition） and 3D-TOF-MRA （3D Time-of-Flight Magnetic Resonance Angiography） in preoperative assessment of hemi-facial spasm.Methods Sixty-nine patients with hemi-facial spasm who have been treated in the hospital from January 2014 to April 2015 were included in our study. 3D-FIESTA and 3D-TOF-MRA were performed for all the patients prior to micro-vascular decompression. Having taken surgical ifndings as the gold standard, the offending vessels determined by 3D-TOF-MRA and 3D-FIESTA were compared clinical outcomes.Results Neuro-vascular contact/compression （NVC） was found more frequently in the symptomatic sides （61/69, 88.4%） than that in the non-symptomatic sides （3/69, 4.3%）. The sensitivity and accuracy of 3D-TOF-MRA and 3D-FIESTA MRI for identifying offending vessels comparing with surgical findings was 88.4% （61/69） and 100%（61/61）, respectively. Comparing with 3D-TOF-MRA or 3D-FIESTA images, the offending vessels were more detected by comprehensive analysis of 3D-TOF-MRA and 3D-FIESTA （P= 0.021 and 0.063, respectively）.Conclusion Preoperative 3D-TOF-MRA and 3D-FIESTA could show the neuro-vascular relationship and help identify the offending vessels for the patients with hemi-facial spasm.