3D-FIESTA-C与3D-TOF-MRA 序列在血管压迫三叉神经痛中责任血管显示的比较研究

目的：比较三维双激发平衡式稳态自由进动序列（3D‐FIESTA‐C）与三维时间飞跃法磁共振血管成像（3D‐TOF‐MRA）在血管压迫三叉神经痛中责任血管显示的应用价值。方法回顾性分析行微血管减压术（M VD ）的60例三叉神经痛患者的磁共振资料，所有患者均采用3D‐T O F‐M RA和3D‐FIES T A‐C序列扫描，从原始及重建图像综合评判患侧三叉神经脑池段与周围血管的空间关系，以术中镜下所见为金标准，对比分析3D‐TOF‐MRA和3D‐FIESTA‐C序列预判接触血管的效能。结果判定是否存在责任血管，3D‐TOF‐MRA和3D‐FIESTA‐C序列灵敏度分别为85．7％、89．3％，特异度为75．0％、100％，准确率为85．0％、90．0％（P＝1．000）。在责任血管中，3D‐TOF‐MRA和3D‐FIESTA‐C序列判定责任动脉灵敏度分别为94．1％、88．2％（P＝0．244），而责任静脉灵敏度为0．00％、88．2％（P＝0．009）。结论3D‐FIESTA‐C与3D‐TOF‐MRA序列均能有效显示责任血管，3D‐FIESTA‐C对责任静脉的显示优于3D‐TOF‐MRA ，可作为术前病因诊断的有力补充。

The comparative study of showing the responsible blood vessels for neurovascular compression in trigeminal neuralgia by 3D-FIESTA-C and 3D-TOF-MRA

Objective To compare the diagnostic efficiency in showing the responsible blood vessels for neurovascular compression in patients with trigeminal neuralgia by 3D‐FIESTA‐C and 3D‐TOF‐MRA sequences .Methods The imaging data of 60 patients with primary trigeminal neuralgia were analyzed retrospectively .After MRI examination ,all of the patients underwent micro‐vascular de‐compression (MVD) .3D‐TOF‐MRA and 3D‐FIESTA‐C sequences were performed to evaluate the three‐dimensional relationship be‐tween trigeminal nerve and blood vessels through the original and reconstructed image .The intraoperative endoscopic findings were set as the gold standard comparing to the manifestations of 3D‐TOF‐MRA and 3D‐FIESTA‐C .Results The sensitivities of 3D‐TOF‐MRA and 3D‐FIESTA‐C for the diagnosis of the existence of responsible vessels were 85 .7% ,89 .3% ,the specificities were 75 .0% , 100% ,and the accuracies were 85 .0% ,90 .0% ,respectively (P=1 .000) .Furthermore ,the sensitivities of 3D‐TOF‐MRA and 3D‐FIESTA‐C for the diagnosis of the existence of responsible arteries were 94 .1% ,88 .2% (P=0 .244) ,while the sensitivities of the responsible veins were 0 .00% and 88 .2% (P=0 .009) .Conclusion Both the 3D‐FIESTA‐C and 3D‐TOF‐MRA sequences can accurately deter‐mine the existence of responsible vessels in trigeminal neuralgia before surgery .3D‐FIESTA‐C sequence is superior to 3D‐TOF‐MRA for presenting the responsible veins ,which can be used as a supplemental diagnostic tool before operation .