磁共振断层血管成像对面肌痉挛病因的诊断价值

目的探讨磁共振断层血管成像(MRTA)对面肌痉挛(HFS)病因诊断的临床应用价值。方法HFS患者52例(观察组)和健康成人20例(对照组)进行MRTA检查,观察3D-TOF成像序列结合3D-CISS序列中脑桥小脑角(CPA)池内面神经与周围血管的关系,并与手术结果进行盲法对照。结果观察组患侧与健侧及对照组相比神经血管接触或压迫差异均有统计学意义(P<0.05),健侧和对照组差异无统计学意义(P>0.05)。MRTA对神经血管接触或压迫的敏感度为94.1%,特异度为86.7%,阳性预测值为88.9%,阴性预测值为92.9%。结论MRTA证实面肌痉挛患者在面神经出脑干段(REZ)存在神经血管接触或压迫。MRTA诊断CPA池内血管接触或压迫敏感度和真实性高。

The clinical significance of MR tomographic angiography in diagnosing the etiology of hemifacial spasm

Objective To investigate the clinical value of MR tomographic angiography(MRTA) in diagnosing the etiology of hemifacial spasm(HFS).Methods Fifty-two patients with HFS and 20 healthy controls underwent MRTA examination.The relationship of the 7th cranial nerve and adjacent vessels was best visualized on the 3D TOF sequence and constructive interference in steady state(CISS) sequence.The results were compared with the outcome of operation blinded.Results The symptomatic sides of the HFS cases had statistical difference compared with the healthy control group in the outcome of operation(P<0.05),the asymptomatic sides hadn't difference yet(P>0.05).The sensitivity,specificity,positive predictive value,and negative predictive value of MRTA were 94.1%,86.7%,88.9%,92.9%.Conclusion It could be confirmed with MRTA that there existed neurovascular contact or compression at the root entry zones of 7th cranial nerve in HFS patients.MRTA is one of valuable method to diagnose the etiology of HFS.