MRTA对原发性高血压病因诊断价值探讨

目的：探讨磁共振断层血管成像（MRTA）显示Ⅸ和Ⅹ颅神经进入脑干段延髓腹外侧神经血管接触的影像解剖关系、对原发性高血压病因的临床诊断价值。方法：46例原发性高血压组和30例正常血压参照组,采用3DTOF-SPGR序列对迷走神经及其周围血管采用高分辨率磁共振（MRI）扫描。成像评估由2名MRI诊断医生在不知道研究对象血压情况下进行阅片。结果：迷走神经颅内段显示良好,原发性高血压组Ⅸ和Ⅹ颅神经进入脑干区延髓腹外侧神经血管有接触者35例（76.08%）;正常参照组3例（10%）。接触或压迫血管为椎动脉或小脑后下动脉。结论：MRTA可作为原发性高血压颅内血管神经接触或压迫病因诊断的一种常规方法。

Value of MRTA for Diagnosis of Cause of Essential Hypertension

Objective To evaluate the clinical usefulness of magnetic resonance tomographic angiography（MRTA）in demonstrating the imaging anatomic relationship of neurovascular contact of the root entry zones of the 9th and 10th cranial nerves of ventrolateral medulla,and to explore its relationship with essential hypertension（EHT）.Methods Forty-six patients with EHT（group EHT）and 30 patients with normal hypertension（control group）underwent high-resolution MRI examination（3D TOF-SPGR series）to scan the 9th and 10th cranial nerves and the near blood vessels.Images were interpreted by tow radiologists who were blinded to the patients hypertensive status.Neurovascular contact was graded as three grades：mild neurovascular contact,clear vessel contact in continuity with the brain stem,obvious vessel contact with compression and deformity of ventrolateral medulla.Results Intracranial vagus nerves were displayed clearly in all cases.Neurovascular contact of the root entry zones of the 9th and 10th cranial nerves of ventrolateral medulla was found in 76.08 %（35 cases）in EHT group,and 10 %（3 cases）in control group.Often the contacting or compression blood vessel was vertebral artery or posterior inferior cerebellar artery.Conclusion MRTA may be used as routine modality to evaluate the neurovascular compression cause of essential hypertension.