三维时间飞跃法MRA及图像后处理技术对血管压迫性三叉神经痛的诊断价值

目的　探讨三维时间飞跃法磁共振血管成像 (3D TOFMRA)及其后处理技术 (MPR)对血管压迫性三叉神经痛的诊断价值。方法　两名神经放射科医师盲法分析 38例临床诊断为三叉神经痛患者的 3D TOFMRA基础图像及MPR图像。结果　 (1) 38例三叉神经痛患者中 ,MRI诊断为血管接触或压迫 31例 ,其中有症状侧血管接触或压迫 2 6例。症状侧与影像上三叉神经存在血管接触或压迫有显著相关 (P <0 0 0 5 )。(2 ) 14例以三叉神经第 2支分布区域疼痛为主要症状的患者中 ,85 .7% (12例 )血管压迫神经的中间部位 ;10例以三叉神经第 3支分布区域疼痛为主要症状的患者中 ,70 % (7例 )血管压迫神经的侧方 (P <0 0 0 5 )。结论　 3D TOFMRA及MPR可清晰地显示三叉神经脑池段与毗临血管的关系 ,血管压迫神经的部位与疼痛的区域有一定的相关性

Diagnostic value of neurovascular compression in trigeminal neuralgia with 3D-TOF MRA and postprocessing techniques

Objective To evaluate diagnostic value of 3D time-of-flight (3D-TOF) magnetic resonance imaging (MRA) and postprocessing techniques in neurovascular compression (NVC) in trigeminal neuralgia.Methods 38 patients with trigeminal neuralgia were examined by 3D-TOF MRA.MRA fundament images and multiplanar reconstruction (MPR) images were blindly interpreted by 2 neuroradiologists.Results (1) Of all the patients, 31 cases showed vascular compression or contact on MR imaging, 26 cases showed the vascular compression or contact at the same side of clinic symptoms. There was a statistic correlation between NVC and trigeminal neuralgia ( P<0.005). (2) 12 (85.7%) of 14 patients with symptoms related to V2 (second branch area of trigeminal nerve) had NVC at the medial site of trigeminal nerve, while 7 (70%) of 10 patients with symptoms related to V3 (third branch area of trigeminal nerve) had NVC at the lateral site of trigeminal nerve ( P<0.005).Conclusion 3D-TOF MRA and MPR may display cistern section of trigeminal nerve and its adjoined vessel. A close relationship was found between the region of neuralgic manifestation and the site of trigeminal nerve compression.