血管压迫性三叉神经痛磁共振表现与手术结果对照分析

目的评估磁共振断层血管成像在血管压迫性三叉神经痛术前诊断中的作用。方法采用磁共振3D-TOF序列扫描60例血管压迫性三叉神经痛患者的三叉神经出脑干段,并做多平面重建。将磁共振表现与其手术结果对照,分析各断面成像的敏感性、特异性和准确性。结果术中发现3例无血管神经接触,3例为静脉接触神经,其余54例均可见动脉或动脉伴静脉一起接触神经。经统计表明以斜矢状面的敏感性、特异性及准确性最高。结论磁共振对血管压迫性三叉神经痛的责任血管的术前评估非常有价值,斜矢状面是最佳成像断面。

Vascular Compressive Trigeminal Neuralgia:Comparative Study on MRI with Surgical Findings

Objective To assess the value of Magnetic resonance tomographic angiography(MRTA) in demonstrating preoperatively vascular compression trigeminal neuralgia.Methods MRTA was performed in 60 patients with unilateral vascular compressive trigeminal neuralgia.Three dimensional time-of-flight(3D-TOF)sequence was used for the MRTA scan.Coronary plane and bilateral oblique-sagittal planes were reconstructed after getting the transverse plane images.The MRTA images were compared to the results of operation.The sensitivity,specificity and accuracy of each scan plane were analysed.Results In operation,3 cases showed no vessel-nerve contact,3 cases only showed vein-nerve contact,vessel-nerve contact could be seen in the other cases.The sensitivity,specificity and accuracy of the oblique-sagittal plane on MRTA were higher than that on other two planes.Conclusion MRI is an useful tool in evaluating the offending vessels of vascular compressive trigeminal neuralgia preoperatively.Oblique-sagittal plane is the best plane to detect the offending vessels.