3.0T磁共振断层血管成像对三叉神经痛和面肌痉挛血管神经压迫的诊断价值

目的 探讨3.0T磁共振断层血管成像(magnetic resonance tomographic angiography, MRTA )对三叉神经痛和面肌痉挛血管神经压迫的诊断价值. 方法 临床诊断的三叉神经痛52例,面肌痉挛9例,共61例.61例均行3.0T磁共振断层血管造影成像( MRTA),利用原始图像进行斜矢状位和冠状位重建,从3个方位观测血管神经的关系,并与手术结果进行对照. 结果 52例三叉神经痛中,MRTA显示46例存在三叉神经血管压迫或接触,6例无压迫.9例面肌痉挛MRTA显示面神经均有微血管跨越或压迫.手术结果显示52例三叉神经痛中45例存在三叉神经血管压迫或接触,6例无压迫,1例为囊肿;9例面肌痉挛均有微血管压迫.MRTA诊断阳性率为90.2%、敏感性为 96.4%、特异性为80%. 结论 3.0T超高场强下进行MRTA,对发现三叉神经痛和面肌痉挛血管神经压迫有重要诊断价值.

Diagnostic Value of Magnetic Resonance Tomographic Angiography with 3.0T Scanner Trigeminal Neuralgia and Hemifacial Spasm

Objective To evaluate the diagnostic value of magnetic resonance tomographic angiography(MRTA) with 3.0T scanner for neurovascular compression in patients with trigeminal neuralgia and hemifacial spasm.Methods MRTA using three-dimensional time-of-flight(TOF) sequence was performed in 52 cases with trigeminal neuralgia and 9 cases with hemifacial spasm.MR oblique sagittal and coronal images were created to display the relationship between trigeminal and facial nerves and surrounding vessels,and compared with that of operation MRA showed that.Results In 52 cases with trigeminal neuralgia,the trigeminal nerves were compressed by vessels or contacted with vessels in 46 cases at MRTA,and in 9 cases with hemifacial spasm,all trigeminal nerves showed having vascular compression or in contact with vessels.The accuracy,sensitivity and specificity of MRA in diagnosing trigeminal neuralgia and hemifacial spasm caused by vascular compression were 90.2%,96.4% and 80%,respectively,which compared with that of operation.Conclusion MRTA is sensitive to neurovascular compression,which plays an important role in diagnosing trigeminal neuralgia and hemifacial spasm.