静脉压迫性原发性三叉神经痛的 MRI 序列研究及诊断价值

目的：探讨静脉压迫性原发性三叉神经痛(PTN)患者责任静脉的最佳 MRI 序列组合。方法回顾性分析26例单独静脉压迫性 PTN 患者33支责任静脉在3D-TOF-MRA、3D-FIESTA 及 CE-3D-TOF-MRA 3种序列上的成像特点及不同序列对责任静脉的显示率。结果33支责任静脉在3D-TOF-MRA 序列上显示率15.2%(5/33)；3D-FIESTA 序列与3D-TOF-MRA+3D-FIESTA 序列组合的显示率均为63.6%(21/33)；CE-3D-TOF-MRA 序列上显示率100%(33/33)。CE-3D-TOF-MRA 序列较3D-TOF-MRA+3D-FIESTA 序列组合对责任静脉的显示率高且有统计学差异(P <0.005)。结论CE-3D-TOF-MRA 对责任静脉的检出率最高，联合使用3种序列，可明确诊断血管性质和压迫情况，减少责任静脉的漏诊。

The study and diagnostic value of MRI sequences in primary trigeminal neuralgia by venous compression

Objective To investigate the best combination of MRI sequences for detecting offending veins in patients with primary trigeminal neuralgia (PTN).Methods 33 offending veins of the 26 PTN patients were analyzed retrospectively on 3D-TOF-MRA sequence, 3D-FIESTA sequence and CE-3D-TOF-MRA sequence.The imaging features and the displaying rate of the 33 offending veins were analyzed.Results Of the 33 offending veins,5 (1 5.2%)were revealed on 3D-TOF-MRA sequence;21 (63.6%)were revealed on 3D-FIESTA sequence alone and 3D-FIESTA sequence combined with 3D-TOF-MRA sequence;33 (100%)were revealed on CE-3D-TOF-MRA sequence.CE-3D-TOF-MRA sequence had a significant higher detection rate than that of 3D-FIESTA sequence combined with 3D-TOF-MRA sequence (P <0.005).Conclusion CE-3D-TOF-MRA sequence has the highest rate for detecting offending veins. Combining 3D-TOF-MRA,3D-FIESTA and CE-3D-TOF-MRA sequences can confirm whether the offending vessel is an artery or a vein,and show more details of the neurovascular compression,which can reduce the probability of missing offending vein.