血管神经成像联合神经电生理监测技术的临床应用

Clinical application of neurovascular imaging combined with neuroelectrophysiological monitoring technology

目的探讨三维多角度优化取样血管神经成像技术(3D-SPACE)及术中侧方扩散反应电生理监测技术(LSR)的临床意义。方法选取2018-08—2021-08于长江航运总医院行微血管减压术的80例面肌痉挛患者为研究对象,A组40例行3D-SPACE MRI血管神经成像技术及术中LSR电生理监测技术;B组仅行常规3D-TOF。比较2组患者术后恢复情况和并发症情况。结果A组术后1周面部抽动缓解率为57.5%;术后6~12个月随访,缓解率90%,治愈率62.5%;术后面瘫率2.5%,听力下降、眩晕率7.5%。B组术后1周缓解率为60.0%;术后6~12个月随访,缓解率70%,治愈率30.0%;术后面瘫率12.5%,听力下降、眩晕率15%。A、B 2组术后1周缓解率及术后不良反应比较,差异无统计学意义(P>0.05)。术后6~12个月随访A组完全缓解率明显高于B组,差异有统计学意义(P<0.05)。结论利用3D-SPACE MRI血管神经成像技术联合术中LSR电生理监测技术,对于远期疗效意义明显,术中从解剖结构及神经功能上给手术医师提供更加可靠、全面的信息,对面、听神经的保护具有重要意义。

Objective Using 3D-SPACE MRI(three-dimensional fast spin echo with variable flip angle)vascular neuroimaging technology and intraoperative LSR(lateral spread response)electrophysiological monitoring technology,to provide surgeons with more reliable and comprehensive information from anatomical structure and neurological function,and to explore the relevant clinical significance.Methods Data of patients with facial spasm who underwent microvascular decompression in our hospital from August 2018 to August 2021 were selected and randomly divided into groups A and B,with 40 cases each.Group A underwent 3D-space MRI vascular neuroimaging and intraoperative LSR monitoring;Group B was treated with conventional 3D-TOF only.The postoperative recovery and complications were compared between the two groups.Results There was no significant difference in the one-week postoperative remission rate and postoperative adverse reactions between the A and B groups(P>0.05).The complete remission rate was 90.0%(36)in group A after 6-12 months after operation,which was significantly higher than 70.0%(28)in group B,and the difference was statistically significant(P<0.05).Conclusion The use of 3D-SPACE MRI vascular neuroimaging technology combined with intraoperative LSR electrophysiological monitoring technology is of great significance for long-term curative effect,and provides surgeons with more reliable and comprehensive information on anatomical structure and neurological function during operation,which is of great significance for the protection of facial and auditory nerves.