磁共振神经成像对典型三叉神经痛压迫位置与疼痛区域相关性的研究

A study of the correlation between the compression location and the painful region in classical trigeminal neuralgia by MRN

目的通过磁共振神经成像来评价典型三叉神经痛患者压迫部位与疼痛区域相关性。材料与方法回顾性分析77例典型三叉神经痛患者的临床及影像学资料。将神经血管压迫部位分为上侧和下侧,由2名放射科主治医师对其进行分类,使用Kappa检验评价两组分类的一致性,运用χ^(2)检验计算压迫位置与疼痛区域间的优势比(odds ratio,OR)值。结果两组分类的Kappa值>0.75,分类的一致性好;来自神经上侧的压迫较来自神经下侧的压迫发生眼支区域疼痛的OR值为1.53,95%CI为1.13~2.07,P<0.05。结论来自三叉神经根上侧的压迫更可能是造成眼支区域疼痛的原因,当影像上发现压迫位置与疼痛分布不符时,避免对此类患者直接行手术治疗,需行外周神经成像并详细询问病史以排除继发性三叉神经痛。

Objective:To evaluate the correlation between the compression site and the pain region in patients with classical trigeminal neuralgia by magnetic resonance neuroimaging.Materials and Methods:Seventy-seven cases of classical trigeminal neuralgia were retrospectively analyzed.The neurovascular compression sites were divided into upper and lower sides,which were classified by two senior radiologists,and the agreement evaluation was performed using the Kappa test.The odds ratio(OR)between the compression location and the painful region was calculated using theχ2 test.Results:The Kappa value of classification in the two groups was>0.75,with good consistency.The OR of ophthalmic branch regional pain was 1.53 for compression from the upper side of the nerve compared with compression from the lower side of the nerve,95%CI was 1.13-2.07,P<0.05.Conclusions:Compression from the upper side of the trigeminal nerve root is more likely to be the cause of pain in the region innervated by the ophthalmic branch.When imaging reveals that the location of compression is not consistent with the distribution of pain,surgical treatment of patients is avoided.At this point,imaging of the trigeminal nerve branches and a detailed clinical history are required to rule out secondary trigeminal neuralgia.