3T MR体层血管造影对血管压迫性三叉神经痛的诊断价值

目的:探讨3T磁共振体层血管造影(MRTA)对血管压迫性三叉神经痛的诊断价值.方法:回顾性分析60例手术治疗的血管压迫性三叉神经痛患者的MRTA表现,评判三叉神经周围有无血管压迫,并与术中观察结果对照.结果:症状侧血管压迫者52例,非症状侧血管压迫5例,两者差异有统计学意义(P＜0.01).MRTA显示的神经血管接触52例中,术中49例发现有血管压迫或接触,MRTA显示无接触的8例中有4例发现血管压迫或接触.以手术结果为金标准,MRTA判断血管压迫性三叉神经痛的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为92.5％、57.1％、88.3％、94.2％和50％.结论:MRTA可以准确显示三叉神经根与周围血管的关系,为血管压迫性三叉神经痛的诊断及治疗提供可靠的影像学依据.

Value of Magnetic Resonance Tomographic Angiography in Diagnosis of Trigeminal Neuralgia at 3T MRI

Purpose:To evaluate the value of magnetic resonance tomographic angiography(MRTA) in display of neurovascular compression in patients with trigeminal neuralgia(TN) at 3T MRI.Methods: MRTA findings and operative results of 60 patients with TN were reviewed retrospectively.The offending vessels surrounding trigeminal nerve were evaluated and correlated with the operation findings. Results:MRTA showed vessel - nerve contact in 52 cases on the symptomatic sides and 5 cases on the asymptomatic sides.The difference was statistically significant,P < 0.01.Of the 52 cases with vesselnerve contact shown on MRTA,49 were shown vascular contact or compression by operation.The sensitivity, specificity,accuracy,positive predictive value and negative predictive value of the diagnosis of vascular - nerve compression by MRTA was 92.5%,57.1%> 88.3%,94.2%,50%,respectively.Conclusion: MRTA could perfectly display the offending vessels of vascular compressive TN and provide credible imaging evidence for pathogenic diagnosis and clinical treatment planning.