MRTA诊断原发性面肌痉挛的临床价值

目的评价MR断层血管成像(MRTA)在原发性面肌痉挛(EHFS)临床诊断中的价值。方法102例确诊单侧EHFS患者和70例正常志愿者,接受双侧面神经MRTA检查,每侧面神经均获取横断面、斜冠状面及冠状面三个断面的图像。结果MRTA显示,患侧面神经血管接触及压迫的阳性率83.33%明显高于健侧13.22%(P<0.01);综合三个断面进行判断,可较任何单一断面获得更高的敏感性(83.33%)、特异性(86.78%)、准确性(85.76%),以及与临床症状的一致性(Kappa=0.672)。结论血管明确接触/压迫面神经征象与临床发生EHFS症状之间有着密切的关系;多平面MRTA成像有助于提高MRI检出血管接触或压迫的敏感性、特异性和准确性。

Clinical Value of MR Tomographic Angiography in the Diagnosis of Essential Hemifacial Spasm

Objective To evaluate MR tomographic angiography (MRTA) in the clinical diagnosis of essential hemifacial spasm (EHFS). Methods MRTA of bilateral facial nerves was performed on 102 established EHFS patients and 70 asymptomatic volunteers as controls. Images of three planes including transverse, oblique coronal and coronal sections were obtained for each patient. Results The positive rate of neurovascular contact/compression (NVC) detected by MRTA in symptomatic sides (83.33%) was significantly higher than that in asymptomatic sides (13.22%)(P<0.01). Comprehensive evaluation based on all three MRTA planes could obtain better sensitivity (83.33%), specificity (86.78%), accuracy (85.76%) and correspondence with clinical symptoms (Kappa= 0.672) than any single plane. Conclusion The signs of neurovascular definite contact and compression detected by MRTA were definitely related with the occurrence of EHFS. Multiplanar MRTA may achieve optimal correspondence with clinical symptoms and improve sensitivity, specificity and accuracy in detecting NVC.