3D-CISS序列MR成像在血管压迫性三叉神经痛中的应用

目的　探讨三叉神经痛患者的神经血管解剖关系。方法　应用 3D -CISS序列并结合 3D -TOF血管造影及MPR重建技术对 49例三叉神经痛患者进行MR检查并部分与手术结果对照。结果　 (1) 13例手术患者中 ,10例 3D -CISS和 3D -TOF序列均显示血管压迫的患者经手术证实为动脉压迫 ,另 3例仅在 3D -CISS序列显示的压迫血管 ,手术证实为静脉压迫。 (2 ) 2 0例伴有上颌神经症状的病人有 18例 (90 % )在三叉神经根部内侧有压迫点 ;19例伴有下颌神经症状的病人有 15例 (79% )在三叉神经外侧有压迫点 (经 χ2 检验 ,P <0 .0 0 1)。结论　 3D -CISS序列对显示三叉神经痛病人的神经血管关系、三叉神经的压迫部位与三叉神经痛区域相关性有重要作用。

Application of 3D-CISS MR Imaging in the Diagnosis of Trigeminal Neuralgia

Objective To evaluate neurovascular anatomical relationship in patients with trigeminal neuralgia.Methods 49 patients with neuralgia were examined by MRI 3D-CISS in combination with 3D-TOF and MPR technique.The MRI findings were compared to the partial operative results.Results 13 patients who underwent surgery were considered as a responsible compression of vessel on 3D-CISS and 3D-TOF imaging,the compression caused by artery and vein was seen in operation in 10 cases and 3 cases respectively.18 (90%) of 20 patients with the symptom of maxillary division had neurovascular compression at the medial site of the root of trigeminal nervus,while 15(79%) of 19 patients with the symptom of mandibular division had compression at the lateral site.Conclusion 3D-CISS MR imaging is useful in the detection of neurovascular relationship and correlation between the region of neuralgic manifestation and the site of trigeminal nerve compression.