Purpose: Is to evaluate the accuracy of fused 3D time-of-flight (TOF) MR angiography and 3D Steady-State sequence (FIESTA) versus 3D contrast-enhanced T1 weighted images in evaluation of neurovascular compression via ...Purpose: Is to evaluate the accuracy of fused 3D time-of-flight (TOF) MR angiography and 3D Steady-State sequence (FIESTA) versus 3D contrast-enhanced T1 weighted images in evaluation of neurovascular compression via an inter-observer agreement protocol. Methods: Patients presented with trigeminal neuralgia, tinnitus, or facial hemispasm were examined using 3D-TOF-MRA, 3D-FIESTA, and 3D contrast-enhanced T1WI of the cerebellopontine angle to assess neurovascular compression. Two independent readers assessed the location, signal alteration, offending vascular structure, and grade of neurovascular compression using fused 3D-TOF-MRA and 3D-FIESTA versus contrast-enhanced T1 weighted images. The Kappa test for interobserver agreement was done. Results: The final study cohort consisted of 56 patients (42 females and 14 males) with a mean age of 38.25 ± 1.94. AICA was the offending vessel for 32 (57.1%) patients. The most common offending nerve was the trigeminal nerve in 26 patients, followed by facial/vestibulocochlear complex in 18 patients, and solely the 8th nerve in 12 patients. All three grades of compression were encountered in this study with percentages of 48.2% (27/56), 30.3% (17/56), and 21.4% (12/56) for grades I, II, III respectively. Fused TOF and steady-state images, and contrast-enhanced images showed perfect agreement for detection of the side of compression, the relation between nerve and vascular loop, offended neural segment, and offending vessel, while showing good agreement regarding the degree of compression. Conclusion: Fused TOF and steady-state images provide sufficient data to diagnose and grade microvascular compression syndromes comparable to contrast-enhanced images.展开更多
目的探讨3.0 T MR三维高分辨成像联合MR仿真内镜(MRVE)在三叉神经痛术前评估中的应用价值。方法回顾性分析2016年4月—2017年12月40例因原发性三叉神经痛(PTN)行微血管减压术(MVD)病人的资料,其中男21例,女19例,年龄37~86岁,平均(59.6&#...目的探讨3.0 T MR三维高分辨成像联合MR仿真内镜(MRVE)在三叉神经痛术前评估中的应用价值。方法回顾性分析2016年4月—2017年12月40例因原发性三叉神经痛(PTN)行微血管减压术(MVD)病人的资料,其中男21例,女19例,年龄37~86岁,平均(59.6±2.2)岁。所有病人均行3.0 T MR三维高分辨成像,进行双激发平衡式稳态自由进动(3D-FIESTA-c)和三维时间飞跃法MR血管成像(3D-TOF-MRA)序列扫描,并进行MRVE重建。采用χ2检验比较三维高分辨成像及三维高分辨成像联合MRVE预判断责任血管的阳性率,并以手术结果作为金标准,分析上述2种成像方法对责任血管的检出率。结果术前40例病人采用2种成像方法检查,MR三维高分辨成像联合MRVE成像对责任血管压迫显示的阳性率(95%,38/40例)高于MR三维高分辨成像(85%,34/40例)(χ2=1.826,P=0.04)。术中发现40例PTN病人均存在责任血管压迫,其中动脉压迫33例(82.5%)、单纯静脉压迫3例(7.5%)、动静脉混合压迫4例(10.0%)。2种成像方法对动脉压迫的检出率均为100%。MR三维高分辨成像联合MRVE成像对静脉及动静脉混合压迫的检出率(71.4%,5/7)高于单独MR三维高分辨成像(14.3%,1/7)。结论 MR三维高分辨成像序列联合MRVE技术能有效显示神经与血管的三维空间关系,能够对三叉神经痛的病因诊断提供重要价值。展开更多
文摘Purpose: Is to evaluate the accuracy of fused 3D time-of-flight (TOF) MR angiography and 3D Steady-State sequence (FIESTA) versus 3D contrast-enhanced T1 weighted images in evaluation of neurovascular compression via an inter-observer agreement protocol. Methods: Patients presented with trigeminal neuralgia, tinnitus, or facial hemispasm were examined using 3D-TOF-MRA, 3D-FIESTA, and 3D contrast-enhanced T1WI of the cerebellopontine angle to assess neurovascular compression. Two independent readers assessed the location, signal alteration, offending vascular structure, and grade of neurovascular compression using fused 3D-TOF-MRA and 3D-FIESTA versus contrast-enhanced T1 weighted images. The Kappa test for interobserver agreement was done. Results: The final study cohort consisted of 56 patients (42 females and 14 males) with a mean age of 38.25 ± 1.94. AICA was the offending vessel for 32 (57.1%) patients. The most common offending nerve was the trigeminal nerve in 26 patients, followed by facial/vestibulocochlear complex in 18 patients, and solely the 8th nerve in 12 patients. All three grades of compression were encountered in this study with percentages of 48.2% (27/56), 30.3% (17/56), and 21.4% (12/56) for grades I, II, III respectively. Fused TOF and steady-state images, and contrast-enhanced images showed perfect agreement for detection of the side of compression, the relation between nerve and vascular loop, offended neural segment, and offending vessel, while showing good agreement regarding the degree of compression. Conclusion: Fused TOF and steady-state images provide sufficient data to diagnose and grade microvascular compression syndromes comparable to contrast-enhanced images.
文摘目的探讨3.0 T MR三维高分辨成像联合MR仿真内镜(MRVE)在三叉神经痛术前评估中的应用价值。方法回顾性分析2016年4月—2017年12月40例因原发性三叉神经痛(PTN)行微血管减压术(MVD)病人的资料,其中男21例,女19例,年龄37~86岁,平均(59.6±2.2)岁。所有病人均行3.0 T MR三维高分辨成像,进行双激发平衡式稳态自由进动(3D-FIESTA-c)和三维时间飞跃法MR血管成像(3D-TOF-MRA)序列扫描,并进行MRVE重建。采用χ2检验比较三维高分辨成像及三维高分辨成像联合MRVE预判断责任血管的阳性率,并以手术结果作为金标准,分析上述2种成像方法对责任血管的检出率。结果术前40例病人采用2种成像方法检查,MR三维高分辨成像联合MRVE成像对责任血管压迫显示的阳性率(95%,38/40例)高于MR三维高分辨成像(85%,34/40例)(χ2=1.826,P=0.04)。术中发现40例PTN病人均存在责任血管压迫,其中动脉压迫33例(82.5%)、单纯静脉压迫3例(7.5%)、动静脉混合压迫4例(10.0%)。2种成像方法对动脉压迫的检出率均为100%。MR三维高分辨成像联合MRVE成像对静脉及动静脉混合压迫的检出率(71.4%,5/7)高于单独MR三维高分辨成像(14.3%,1/7)。结论 MR三维高分辨成像序列联合MRVE技术能有效显示神经与血管的三维空间关系,能够对三叉神经痛的病因诊断提供重要价值。
