桥小脑角池横截面积参数与原发性三叉神经痛的相关性研究

Correlation study between the cross-sectional area parameters of cerebellopontine angle cistern and primary trigeminal neuralgia

目的探讨桥小脑角池横截面积预测原发性三叉神经痛(Primary trigeminal neuralgia,PTN)发病与评估微血管减压术(Microvascular decompression,MVD)预后的应用价值。方法回顾性分析54例均经MVD治疗的PTN病例资料(PTN组),测量桥小脑角池横截面积并计算面积偏离度;并以21例健康志愿者作为对照(对照组)。分析可能影响PTN治疗的相关因素。结果桥小脑角池横截面积,在对照组两侧间差异无统计学意义(P>0.05);而PTN组病人患侧比健侧小,差异具有统计学意义(P=0.002)。与对照组比较,桥小脑角池面积偏离度在PTN组患侧较小,差异具有统计学意义(P<0.001)。根据MVD疗效,分为复发组(n=15)与非复发组(n=39)。桥小脑角池面积偏离度,复发组比非复发组小,差异具有统计学意义(P=0.034);左侧疼痛比右侧更易复发,差异具有统计学意义(P=0.018)。结论桥小脑角池面积较小和桥小脑角池面积偏离度较小可作为预测PTN发病的指标。桥小脑角池面积偏离度较小的PTN病人,MVD疗效较差。左侧PTN比右侧更易复发。

Objiective To investigate the value of cross-sectional area parameters of the cerebellopontine angle（CPA） cistern for predicting primary trigeminal neuralgia（PTN） and evaluating prognosis of microvascular decompression（MVD）. Methods The clinical data of 54 patients with PTN（PTN group） undergoing MVD were analyzed retrospectively. The cross-sectional area and the area deviation of the CPA cistern were measured. There were 21 healthy volunteer（control group） as comparison. The relevant factors maybe affecting therapy in PTN were analyzed. Results The cross-sectional area of bilateral CPA cistern was not statistically significant in control group（P〈0.05）. In PTN group, the cross-sectional area of CPA cistern in the affected side was smaller than that in the healthy side and there was a significant statistical difference（P = 0.002）. The area deviation of CPA cistern in PTN group was smaller than that in control group and the difference was statistically significant（P〈0.001）. According to the efficacy of MVD, 54 PTN patients were divided into recurrence group（n = 15） and non-recurrence group（n = 39）. The area deviation of CPA cistern in recurrence group was smaller than that in non-recurrence group and there was statistical significance（P = 0.034）. The PTN of left side was more likely to relapse than right side with statistical significance（P = 0.018）. Conclusions Smaller cross-sectional area and area deviation of CPA cistern are the predictive index of PTN. The MVD treatment is worse in PTN patients with smaller area deviation of CPA cistern. PTN is more likely to recur on the left side than on the right.