颅神经血管压迫症的MR血管断层表现与微血管减压术疗效的相关性

目的 探讨颅神经血管压迫症的MR血管断层成像(MRTA)的表现与微血管减压术疗效之间的相关性.方法 回顾性分析223例行颅神经微血管减压术的患者,根据患者MRTA中的血管对神经的压迫程度和术后疗效进行分组、分级.223例患者分为无压迫组、轻度压迫组及重度压迫组;微血管减压术疗效分为3级,Ⅰ级为完全缓解、Ⅱ级为基本缓解,Ⅲ级为无缓解.用秩和检验的Kruskal-Wallis法比较无压迫组、轻度压迫组及重度压迫组各组间的手术疗效有无统计学差异;用Nemenyi法作各组间手术疗效优劣的两两比较.结果 微血管减压术后缓解程度,无压迫组Ⅰ级为31例,Ⅱ级为13例,Ⅲ级为9例;轻度压迫组Ⅰ级为95例,Ⅱ级为11例,Ⅲ级为4例;重度压迫组Ⅰ级为48例,Ⅱ级为7例,Ⅲ级为5例.三组之间手术疗效的差异具有统计学意义(秩和检验值χ2=16.84,P<0.05).无压迫组、轻度压迫组与重度压迫组的平均秩次分别为134.21、102.37及110.04.轻度压迫组、重度压迫组与无压迫组的平均秩次之差分别为31.84、24.17,P值均<0.05.结论 微血管减压术疗效与术前MRTA的表现具有密切相关性;轻度压迫组和重度压迫组的手术疗效优于无压迫组;MRTA对于微血管减压术适应证的选择及手术预后有指导作用.

Correlation of MR tomographic findings and microvascular decompression treatment of the neurovascular compressions of the cranial nerves

Objective To explore the correlation of the operation effects of the miorovascular decompression(MVD) and the findings on magnetic resonance tomographic angiography(MRTA) in patients of neurovascular compression of the cranial nerves.Methods Two hundred and twenty three patients treated with the microvascular decompression were analyzed retrospectively.They were grouped and graded according to the vessel compression on the cranial nerves.The compression were grouped as none, moderate and severe, and the operation effects were graded as Ⅰ ( complete relief), Ⅱ ( partial relief) and Ⅲ ( no relief).The operation effects grades were correlated according to the compression groups by Kruskal-Wallis test and the operation effects between each two of the groups were compared using Nemenyi test.P < 0.05 was defined as statistic significant.Results Of the 53 cases of non-compression group, 31 cases were graded as Ⅰ , 13 cases were graded as Ⅱ and 9 cases were graded as Ⅲ, according to the operation-effects of the decompression.Of the 110 cases of moderate group,95 cases were grade as Ⅰ , 11 cases were graded as Ⅱ and 4 cases were graded as Ⅲ.Of the 60 cases of severe group, 48 cases were graded as Ⅰ, 7 cases were graded as Ⅱ and 5 cases were graded as Ⅲ.There were statistic significance among the three groups,where χ2= 16.84 and P <0.05.The mean rank of the non-compression, the moderate and the severe group was 134.21,102.37 and 110.4 ,respectively.The difference of the mean ranks between the non-compression group and the moderate group was 31.84, and between the non-compression and the severe group was 24.17, respectively, where P < 0.05 both.Conclusions There was close relationship between the findings on magnetic resonance tomographic angiography and the operation effects of the MVD.The operation effects of patients with moderate and severe vessel compression were much better than the non-compression group.MRTA is helpful for MVD surgical indication and its prognosis.