原发性三叉神经痛中神经血管关系的 MR 应用研究

摘要

Objective :To discuss the applied value of three dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) and three-dimensional fast imaging employing steady-state acquisition(3D-FIESTA)used displaying the relationship between the nerve and vessels in Trigeminal Neuralgia .Methods :Retrospective analysed 29 MR images of PTN patients including 3D-FIESTA and 3D-TOF-MRA from June 2010 to February 2012 ,10 cases compared sur-gery .Results:The positive rate of displaying bilateral trigeminus was 100% ,the positive rate of displaying vessels tight-ening contacting trigeminus were 86 .2% with 3D-FIESTA and 82 .8% with 3D-TOF-MRA ,there were no significant difference (P>0 .1) .The positive rate combining 2 sequences was 93% ,exceeding each ,but no statistically significant (P>0 .1) .Conclusion:MRI could provide information for therapeutic schedule and etiological factors of trigeminal neu-ralgia .And 3D-FIESTA corresponded to 3D-TOF-MRA .Combining two could enhance the positive rate and showed more explicit local details .%目的：探讨磁共振3D-FIESTA（三维快速平衡稳态进动）序列、3D-TOF-MRA序列对显示原发性三叉神经痛（primary trigeminal neuralgia ，PT N ）患者神经血管关系的应用价值。方法：回顾性分析2010年6月-2012年2月共29例临床诊断原发性三叉神经痛患者3D-FIES T A序列及3D-T O F-M RA序列图像中神经血管关系，其中10例对照手术。结果：29例双侧三叉神经显示率100％；3D-FIES T A、3D-T O F-M RA序列显示患侧与神经紧密相临血管阳性率分别为86．2％、82．8％，二者差异无统计学意义（ P＞0．1）；二序列同时应用阳性率93％（27/29），高于单用一序列，但无统计学意义（ P＞0．1）。结论：M RI能为三叉神经痛病因分析和治疗方案的制定提供信息，3D-FIES T A序列及3D-TOF-MRA序列显示神经血管关系价值相当，二者同时应用可以提高神经周围血管显示阳性率，并能更为明确地显示局部细节。