3D-TOF磁共振血管成像诊断血管压迫性三叉神经痛的价值

目的　探讨增强薄层三维体积扫描时间飞跃法磁共振血管成像 ( 3D -TOFMRA)诊断血管压迫性三叉神经痛的价值。方法　回顾性分析 37例临床拟诊为血管压迫性三叉神经痛患者的常规颅脑MRI及增强薄层 3D -TOF磁共振血管成像资料。结果　增强薄层 3D -TOFMRA发现 37例中 2 4例共 2 7侧三叉神经存在血管压迫或接触 ,其中症状侧三叉神经有血管压迫或接触 2 4例 ,无症状侧三叉神经有血管压迫或接触 3例 ,本组病例统计学分析表明 ,三叉神经痛患者症状的出现与三叉神经存在血管压迫或接触有显著相关关系 (Ρ <0 .0 0 5 )。 13例为非血管压迫性三叉神经痛。压迫三叉神经的血管为小脑上动脉 (SCA) 14例 ,小脑前下动脉(AICA) 5例 ,起源不清的血管 3例 ,扭曲的椎动脉 1例 ,血管畸形 1例。结论　增强薄层 3D -TOFMRA可清楚显示三叉神经脑池段与毗邻血管的关系 ,明显优于常规颅脑MRI,是目前检测血管压迫性三叉神经痛最佳的影像学检查方法 ,对明确诊断和指导治疗三叉神经痛具有重大意义。

The Contribution of 3D-TOF MRA in Evaluation of Neurovascular Compression in Patients with Trigeminal Neuralgia

Objective To study the contribution of enhanced 3D time-of-flight MRA in the diagnosis of neurovascular compression in the patients with trigeminal neuralgia.Methods Enhanced 3D time-of-flight MRA and MRI in 37 patients clinical suspected trigeminal neuralgia were analyzed retrospectively.Results We found 27 sides trigeminal nerve in 24 patients were compressed by vascular in the enhanced 3D time-of flight MRA.In 24 patients neurovascular compression was ipsilateral with trigeminal neuralgia,and the side without trigeminal neuralgia, vascular compression in 3 cases were found.There was statistics correlation between neurovascular compression and trigeminal neuralgia.The other 13 patients with trigeminal neuralgia were non-neurovascular compression.The trigeminal nerve was compressed by superior cerebellar artery in 14 patients,anterior inferior cerebellar artery in 5 patients,tortuous vertebral artery in 1 patient,malformation of vascular in 1 patient,other microvascular in 5 patients.Conclusion Enhanced 3D time-of-flight MRA,which is super than MRI,can clearly display trigeminal nerve and neighboring vascular.Int is the optimum technology of radiology to diagnose the neuroveascular trigeminal neuralgia and helpful for diagnosis and treatment.