磁共振断层血管成像对颅神经血管压迫综合征的诊断价值

Diagnostic Value of Magnetic Resonance Tomographic Angiography in the Diagnosis of Cranial Neurovascular Compression Syndrome

目的探讨磁共振断层血管成像(magnetic resonance tomographic angiography,MRTA)对颅神经血管压迫综合征病因诊断的临床应用价值。方法收集颅神经血管压迫综合征患者158例,其中原发性三叉神经痛107例,面肌痉挛46例,舌咽神经痛5例,回顾性分析MRTA检查中3D-FIESTA、3D-TOF及3D-CE-TOF序列图像资料并与手术结果进行对照,评价MRTA检查中不同序列在术前观察颅神经与周围血管的空间关系。结果与微血管减压术(microvasular decompression,MVD)中所见结果对照,发现3D-FIESTA、3D-TOF与3D-CE-TOF序列对显示颅神经受压与责任血管关系的能力方面有统计学差异(P<0.05),独立应用3D-CE-TOF序列对显示颅神经受压责任血管的能力最佳(阳性率95.57%),3D-FIESTA联合3D-TOF序列可提高导致其受压的责任血管阳性检出率(阳性率93.04%),3D-FIESTA联合3D-TOF序列与单独应用3D-CE-TOF序列比较,责任血管阳性检出率无统计学差异(P>0.05)。结论 MRTA技术能清楚显示目标颅神经及导致其受压的责任血管,其中以3D-FIESTA联合3D-TOF序列或独立应用3D-CE-TOF序列显示二者关系最佳。

Objective To explore the clinical value of magnetic resonance tomography angiography（MRTA）in the etiological diagnosis of cranial neurovascular compression syndrome.Methods A total of 158 patients with cranial neurovascular compression syndrome were selected（involving 107 primary trigeminal neuralgia,46 facial spasm and 5 glossopharyngeal neuralgia）.The imaging data of MRAT（including 3D-FIESTA,3D-TOF and 3D-CE-TOF sequence）,surgical results were retrospectively analyzed and compared,and the spatial relationship between cranial nerve and its peripheral vessel in preoperative were evaluated.Results Compared with the results of microvasular decompression（MVD）,the ability for showing relationship of cranial nerve and corresponding vessels among 3D-FIESTA,3D-TOF and 3D-CE-TOF sequence was significatly different（P0.05）.3D-CE-TOF sequence only did best showing cranial nerve and compression vessels（positive rate 95.57%）.3D-FIESTA and 3D-TOF sequence combination improved positive detection rate of corresponding vessels for cranial nerves compression（positive rate 93.04%）.There was no significant difference between single 3D-CE-TOF sequence and 3D-FIESTA combing with 3D-TOF sequence in positive detection rate of corresponding vessels（P0.05）.Conclusion MRTA can definitely display cranial nerves and its corresponding vessels.Single 3D-CETOF,3D-FIESTA combing with 3D-TOF show the best clinical values among these MRTA sequences.