运用3DT1 SPGR序列研究三叉神经与血管的关系

目的:研究MRI3DT1SPGR序列对三叉神经痛(TN)病因诊断的临床价值。材料和方法:常规MRI加3DT1SPGR序列行脑干薄层扫描60例TN患者,采用盲法确定三叉神经根部解剖改变,分别观察双侧三叉神经周围是否存在血管影,并测定三叉神经长轴与邻近血管的距离,两侧对照分析。结果:(1)3DT1SPGR法发现症状侧血管神经之间有切迹者17例,接触者24例,阳性率71%。非症状侧阳性率22%。有三叉神经痛症状的一侧血管接触、压迫神经的比率明显高于非症状侧;(2)MRI常规扫描发现有三叉神经症状的一侧血管压迫神经比率为42%,非症状侧为12%。结论:MRI加3DT1SPGR序列为目前TN病因诊断的较好影像检查方法,TN的主要病因为患侧三叉神经根部受血管压迫。

A Study of Relationship between Trigeminal Nerves and Vessels Using 3D SPGR Sequence

Purpose: To evaluate the clinical value of the three-dimensional spoiled gradient echo(3D SPGR) MRI sequence in the etiological diagnosis of trigeminal neuralgia(TN). Materials and Methods: Conventional MRI and 3D SPGR sequence were performed in 60 patients with TN.The anatomic changes of bilateral trigeminal nerves were observed and the distance from the trigeminal nerves to it's surrounding vessels were measured. Results: (1) The 3D SPGR sequence demonstrated vessels indentation in 17 cases and contiguity in 24 cases on the symptomatic side (positive rate 71%), while on the unsymptomatic side it was in 4 and 9 cases respectively (positive rate 22%). The significance was showed by the chi-square test; (2)The conventional MRI demonstrated that positive sign was 42% on the symptomatic side and 12% on the unsymptomatic side respectively. Conclusion: The conventional MRI combined with 3D SPGR sequence is a very useful technique in diagnosis of TN; The major cause of TN is the close relatinship between trigeminal nerve and it's surrounding vessels.