3D-TOF-MRA多模式成像在面肌痉挛显微血管减压术中的价值

Value of 3D-TOF-MRA multimode imaging for microvascular decompression of hemifacial spasm

目的探讨3D-TOF-MRA多模式成像在面肌痉挛显微血管减压术中的价值。方法 49例面肌痉挛病人用1.5T磁共振机行3D-TOF序列轴位扫描,实验组为神经外科手术医师在影像工作站分别用多平面重建、最大信号强度投影、透明化彩色容积再现等成像模式及合适的成像参数,进行多层面多角度观察,诊断神经血管压迫点及责任血管。对照组为在PACS工作站的诊断结果。以手术所见为金标准,计算2组诊断符合率。结果 49例均在术中发现责任血管及明确压迫点,实验组压迫点诊断符合率83.7%,对照组51.0%,2组比较差异有统计学意义(P<0.05)。实验组责任血管诊断符合率81.6%,对照组65.3%,2组比较差异有统计学意义(P<0.05)。结论神经外科手术医师在影像工作站行3D-TOF-MRA多模式成像,对面肌痉挛病人神经血管压迫点和责任血管的诊断符合率优于在PACS工作站诊断。

Objective To explore the value of multi-mode 3D-TOF-MRA imaging for microvascular decompression of hemifacial spasm.Methods 49 cases of hemifacial spasm underwent 3D-TOF axial scan with 1.5T magnetic resonance machine.The experimental group underwent multiplane reconstruction,maximum intensity projection,transparent color volume rendering with appropriate imaging parameters at the imaging workstation.Multilayer and multi-direction observation was performed by neurosurgeons to diagnose neurovascular compression points and offending vessels.The control group was diagnosed at PACS workstation.The diagnostic coincidence rate of the two groups was calculated according to the intraoperative findings.Results The offending vessels and compression points were found in 49 cases.The diagnostic coincidence rate of compression points was 83.7%in the experimental group and 51.0%in the control group with significant difference(P<0.05).The diagnostic coincidence rate of the offending vessels was 81.6%in the experimental group and 65.3%in the control group with significant difference(P<0.05).Conclusion It is better that neurosurgeons perform 3D-TOF-MRA multi-modality imaging on imaging workstation to judge neurovascular compression points and offending vessels in patients with hemifacial spasm than that on PACS workstation.