血管压迫性三叉神经痛的3D-TOF-MRA序列磁共振成像与手术结果对照

目的探讨3D-TOF-MRA序列对血管压迫性三叉神经痛的诊断价值,并分析其MRI表现。方法回顾性分析26例三叉神经痛患者MRI表现及手术结果。结果3D-TOF-MRA序列显示三叉神经脑池段清晰14例,发现责任小动脉18条,与三叉神经接触16条,压迫2条;三叉神经显示欠清晰12例,发现责任小动脉18条。术中证实责任血管共48条,小动脉38条,静脉10条。3D-TOF-MRA序列显示责任血管的阳性率为75%,其中小动脉为95%,静脉为0。结论3D-TOF-MRA序列能清晰显示小动脉压迫性三叉神经痛的责任血管,并具有较高的阳性率,对提供患者术前评估和指导治疗具有极其重要的意义。

Correlative study of 3D-TOF-MRA and operative results in trigeminal neuralgia associated with neurovascular compression

Objective To evaluate MRI findings and diagnostic value of 3D time-of-flight MRA on trigeminal neuralgia. Methods MR manifestations and operative results of 26 patients with trigeminal neuralgia were retrospectively reviewed. Results Sixteen offending vessels had artery-nerve contact, and 2 had artery-nerve compression in 18 vessels of 14 patients whose trigeminal nerves were displayed clearly. Twelve patients whose trigeminal nerves were displayed unclearly showed eighteen offending vessels. Thirty-eight arteries and ten veins were verified as offending vessels by the operation. The positive rate of offending vessels of 3D-TOF-MRA was 95% and 0 for artery and vein,respectively, and the average rate was 75%. Conclusion 3D-TOF-MRA has high positive rate in diagnosing artery compression or contact, and it plays an important role in preoperative evaluation and treatment.