3D-VIBE序列对血管压迫性三叉神经痛和面肌痉挛诊断价值

目的探讨3.0 T磁共振3D扰相梯度回波(3D-VIBE)序列对于三叉神经痛和面肌痉挛责任血管的诊断价值。方法利用3D-VIBE的原始图像重建,从不同的角度观察神经与血管的走行关系,发现责任血管,并与临床微血管减压术(MVD)进行比对。结果进行3D-VIBE序列扫描后发现责任血管,与术中所见基本符合。血管呈高信号,神经呈等信号,对比良好,能够直观显示血管与神经的解剖结构。三叉神经痛的症状侧的血管压迫阳性符合率为90.6%(29/32),面肌痉挛的症状侧的血管压迫阳性符合率为89.4%(17/19)。结论 3D-VIBE序列对于发现血管压迫性三叉神经痛和面肌痉挛责任血管,明确血管与神经的关系有诊断价值。

The value of MR 3D-VIBE sequence in diagnosis of trigeminal neuralgia and hemifacial spasm caused by vascular compression

Objective To evaluate the diagnostic value of 3. 0T MR(3D-VIBE) sequence in finding the offending vessels of trigemi-nal neuralgia and hemifacial spasm. Methods The images of 3D spoiled gradient echo sequence were reconstructed to observe the re-lationship between vessels and nerves from different angles,the offending vessels were detected and microvascular decompression was compared. Results There were great contrast and anatomic structure between vessels( hyperintensity ) and nervous( isointensity) . The positive coincidence of vessels compression was 89. 4%( 17/19 ) in the patients with facial spasm lateral and 90. 6%( 29/32 ) in the patients with trigeminaI neuralgia. Conclusion There is an important diagnostic value using 3D-VIBE sequence to find the offending vessels of vascular compressive trigeminal neuralgia and hemifacial spasm,especifically to identify the relationship between nerves and blood vessels. Furthermore,the technique is a guide of clinical diagnosis.