3D-T2-DRIVE联合3DTOFMRA诊断面听神经微血管压迫的意义探讨

目的探讨应用3D-T2-DRIVE联合3D TOFMRA诊断面听神经血管性压迫的意义。材料与方法 36例临床拟诊面听神经血管压迫患者行3D-T2-DRIVE与3D TOFMRA序列的各向同性和等体素扫描,观察各例原始图和各方位重组图,评价其显示患侧面听神经、责任血管的效果,由差至优分别记0~3分。分别比较3D-T2-DRIVE、3D TOFMRA及3D-T2-DRIVE+3D TOFMRA三种方法在显示患侧面听神经、责任血管的差异。结果行Kruskal-Wallis H检验,以P0.01为差异有统计学意义。结果在显示面听神经方面,3D-T2-DRIVE+3D TOFMRA优于3D TOFMRA(H=58.78,P=0.0000),T2-3D-DRIVE优于3D TOFMRA(H=53.18,P=0.0000),3D-T2-DRIVE+3D TOFMRA、T2-3D-DRIVE间差异无统计学意义(H=2.28,P=0.1313);在显示责任血管方面,3D-T2-DRIVE+3D TOFMRA优于T2-3D-DRIVE(H=54.12,P=0.0000)和3D TOFMRA(H=62.42,P=0.0000),3D-T2-DRIVE与3D TOFMRA间差异无统计学意义(H=0.0083,P=0.9274)。36例中,3D-T2-DRIVE+3D TOFMRA检出面听神经根性细动脉压迫阳性32例,阴性4例,分别为手术和随访证实,诊断灵敏度100%,特异度100%。结论 3D-T2-DRIVE联合3D TOFMRA技术是诊断面听神经血管压迫性病变的精准方法。

Evaluation of the role of 3D-T2-DRIVE combining 3D TOF MRA in diagnosing microvascular compression for facial-acoustic nerves

AbstractObjective:To evaluate the application value of 3D-T2-DRIVE combining 3D TOF MRA in detecting microvascular compression for facial-acoustic nerves.Materials and Methods:Thirty-six patients were enrolled in the study with clinically suspected vascular compression of facial-acoustic nerves, of which both 3D-T2-DRIVE and 3D TOFMRA sequences images were obtained of isotropy and identical voxel size. Source images and reformatted images were observed to evaluate the effects on demonstration of facial-acoustic nerves and culprit vessels, which was scored from 0 to 3 points in the order from poor to excellent. The differences were compared of effects on displaying both the facial-acoustic nerves and culprit vessels among the three approaches of 3D-T2-DRIVE, 3D TOFMRA, and 3D-T2-DRIVE+3D TOFMRA. TheKruskal-Wallis H test was employed in data processing, withP<0.01 for the statistically signiifcant difference. Results:In displaying facial-acoustic nerves, 3D-T2-DRIVE+3D TOFMRA and T2-3D-DRIVE were superior to 3D TOFMRA (H=58.78,P=0.0000.H=53.18,P=0.0000. respectively), and no statistically signiifcant difference existed between 3D-T2-DRIVE+3D TOFMRA and T2-3D-DRIVE (H=2.28,P=0.1313). In displaying culprit vessels, 3D-T2-DRIVE+3D TOFMRA was superior to T2-3D-DRIVE and 3D TOFMRA (H=54.12, P=0.0000.H=62.42,P=0.0000. respectively), and no statistically significant difference existed between 3D-T2-DRIVE and 3D TOFMRA (H=0.0083,P=0.9274). Of 36 patients,
32 were detected with arteriolar compression for facial-acoustic nerves by the approach of 3D-T2-DRIVE combining 3D TOFMRA, and 4 with no compression. The results were conifrmed by surgical ifndings or clinical follow-up, respectively. The sensitivity and speciifcity was 100%, 100% of 3D-T2-DRIVE+3D TOFMRA in diagnosing microvascular compression for facial-acoustic nerves, respectively. Conclusions:The approach of 3D-T2-DRIVE combining 3D TOF MRA provides an precise and accurate diagnosis of micorvascular compression for facial-acoustic nerves.