三维时间飞跃MRI血管成像在面肌痉挛微血管减压术中价值

Role of three dimension-time on flight MRI angiography in the guidance of microvascular depression surgery for hemifacial spasm

目的探讨三维时间飞跃MRI血管成像(three dimension-time of flight magnetic resonance angiography,3D-TOF-MRA)在显微血管减压术治疗面肌痉挛中的价值。方法 55例面肌痉挛患者均于显微血管减压术前及术后7d行3D-TOF-MRA检查,比较术前、术后面神经根与责任血管关系,记录术中所见。结果术前患侧3D-TOF-MRA检查显示面神经根与责任血管接触50例,可疑接触3例,无接触2例;术中见面神经根与责任血管接触50例,可疑接触4例,无接触1例;术后患侧3D-TOF-MRA检查显示面神经根与责任血管接触13例,可疑接触24例,无接触18例;术前3D-TOF-MRA结果与术中比较差异无统计学意义(P>0.05),与术后3D-TOF-MRA比较差异有统计学意义(P<0.05)。结论面肌痉挛患者微血管减压术前行3D-TOF-MRA检查可明确面神经和责任血管的关系,指导手术操作。

Objective To investigate the role of three dimension-time on flight（3D-TOF-MRA）in the treatment of microvascular depression for hemifacial spasm（HFS）.Methods Fifty-five patients with HFS received 3D-TOF-MRA before microvascular depression surgery and 7dafter operation.The relationship of facial root with corresponding vessels was compared before operation and after operation and the intraoperative findings were observed.Results Preoperative ipsilateral 3D-TOF-MRA results showed that facial root contacted with the responsible vessel in 50 cases,suspiciously contacted in 3cases and not contacted in 2cases.The surgery revealed that the facial root contacted with the responsible vessel in 50 cases,suspiciously contacted in 4cases and not contacted in 1case.Postoperative ipsilateral 3D-TOF-MRA results showed that the facial root contacted with the responsible vessel in 13 cases,suspiciously contacted in 24 cases,and not contacted in 18 cases. There were significant differences between the preoperative and postoperative3D-TOF-MRA finding（P〈0.05）and no significant difference between preoperative and intraoperative findings（P〉0.05）.Conclusion Since 3D-TOF-MRA could identify the relationship between the facial nerve and the corresponding vessels,it can guide the operation procedures.