磁共振成像技术在原发性三叉神经痛微血管减压术前诊断中的应用

目的探讨磁共振成像技术(MR)在原发性三叉神经痛微血管减压术前诊断中的应用价值。方法由神经外科医师及2名神经放射科医师共同参与,盲法分析88例临床诊断为原发性三叉神经痛患者,经过三维时间飞跃磁共振血管成像(3D-TOF)图像,对照应用开颅微血管减压术术中探查结果及术后疗效进行分析。结果 88例原发性三叉神经痛患者中,术前行MR检查,在3D-TOF序列图像上显示血管神经压迫症状侧阳性率86.4%(76/88),非症状侧阳性率12.5%(11/88),两侧阳性率差异有统计学意义(P<0.05)。手术所见周围血管压迫神经者83例(94.3%),未压迫神经者5例(5.7%),3D-TOF诊断符合率97.6%(81/83)。术后症状消失或缓解81例(92.0%)。结论 MR可清楚地显示三叉神经与邻近血管的关系,原发性三叉神经痛微血管减压术具有较高的临床应用价值。

Magnetic resonance imaging in the preoperative diagnosis of idiopathic trigeminal neuralgia microvascular decompression

Objective To discuss the diagnosis value of magnetic resonance imaging in micro-vascular decompression of idiopathic trigeminal neuralgia.Methods Blinded analysis of 88 cases diagnosed with idiopathic trigeminal neuralgia in patients with 3D-T0F,by a neurosurgeon and two radiologists to participate in nerve,to compare intraoperative exploration and curative effect of micro-vascular decompression craniotomy control.Results 88 cases of idiopathic trigeminal neuralgia in patients with preoperative 3D-T0F sequence of images shows symptoms of neurovascular compression side of the positive rate of 86.4%（76/88）,non-symptom side of the positive rate of 12.5%（11/88 ）,the positive difference was significant（P〈0.05）.During the operation,83 cases（94.3%） were found neurovascular compression and 5 cases（5.7%） without neurovascular compression,the symptoms dispeared or relieved in 81 cases（92.0%） after operation.Conclusion MR can clearly show the trigeminal nerve and the relationship between the neighboring blood vessels,with high clinical value.