MRTA对三叉神经痛和面肌痉挛的诊断价值

目的:探讨磁共振断层血管成像(magnetic resonancetomographic angiography,MRTA)对诊断三叉神经痛和面肌痉挛血管神经压迫的价值.方法:临床诊断的三叉神经痛11例,面肌痉挛13例,行三维时间飞越破坏性稳态梯度回波序列(3DTOF-SPGR)采集图像,利用原始图像对两侧三叉神经和面神经进行斜矢状位和冠状位重建,观测血管神经的关系.结果:11例三叉神经痛中,MRTA显示9例存在三叉神经血管压迫或接触,阳性率为81.8%(9/11),可疑接触2例.13例面肌痉挛中有12例显示了面神经起始段有微血管跨越或对面神经有轻微的推压改变,阳性率为92.3%(12/13).结论:MRTA对发现三叉神经痛和面肌痉挛血管神经压迫具有重要价值,MRTA原始图像及斜矢状位和冠状位重建是显示神经血管接触的敏感方法,对选择手术方式具有重要的指导意义.

MR tomographic angiography diagnostic value for trigeminal neuralgia and hemifacial spasm

Objective:To evaluate magnetic resonance tomographic angiography(MRTA) for diagnostic value of neurovascular compression in patients with trigeminal neuralgia and hemifacial spasm.Methods:Three-dimensional (3D) time-of-flight(TOF) spoiled gradient-echo(SPGR) sequence were performed on 11 cases of trigeminal neuralgia and 13 cases of hemifacial spasm.Oblique sagittal and coronal views were created to display the relationship between facial and trigeminal nerves and surrounding vessels.Results:Nine cases of trigeminal nerve had vascular compression or contact at MRTA in eleven trigeminal neuralgia,positivity was 81.8%.Two cases had uncertain vascular contact.Among twelve cases showed vascular compression of contact in facial nerve,and positivity was 92.3%.Conclusion:MRTA has an important value for diagnosing neurovascular compression or contact in patients with trigeminal neuralgia and hemifacial spasm.MRTA primary images,oblique sagittal and coronal reconstruction are sensitive to neurovascular compression,which plays an important role in selecting surgical planning.