面听神经脑池-内耳道段及与邻近血管关系的磁共振研究

发布时间：2018-01-14 20:14

本文关键词：面听神经脑池-内耳道段及与邻近血管关系的磁共振研究　出处：《河北医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:MRI因具有很高的组织分辨力,可以清晰显示出脑池-内耳道段的面听神经及其邻近血管的走行,对面听神经与周围血管关系的诊断具有理想的作用。本课题运用3.0MR对正常人面听神经脑池-内耳道段及周围解剖关系进行研究,包括测量面听神经本身的结构数据及功能成像,并对面听神经与周围血管解剖关系进行详细分类,进而对面听神经相关疾病的临床诊断奠定基础。方法:1收纳健康志愿者105例,记录志愿者基本信息如年龄、性别、临床症状和体征,排除头部手术及面听神经引起的面肌痉挛、神经性耳聋等症状于我院行MR T2FLAIR、3D-TOF序列及3D-FIESTA序列检查。并通过常规T2FLAIR图像排除志愿者脑梗死、颅内肿瘤、脑干、桥小脑角区占位性病变、岩骨畸形等疾病,3D-FIESTA序列图像用于面听神经的重组与测量。3D-TOF序列用于区分面听神经周围的动静脉。2利用3D-FIESTA序列对图像进行冠、矢状面重建,仔细观察神经的走行、粗细、形态等情况,测量面听神经脑池-内耳道段的长度,并分别统计左右两侧面听神经长度有无差异性。3将脑池-内耳道段中内耳道段内有无血管袢以及血管袢探入的深度分为三种类型:Ⅰ型,内耳道段不存在血管袢;Ⅱ型,在内耳道段存在血管袢,但是血管袢进入深度不足内耳道深度50%;Ⅲ型,为内耳道段存在血管袢,并且进入深度超过内耳道段深度的50%。4仔细观察邻近血管与神经距离最近处的部位,测量血管与神经的距离,根据测量的距离将血管与神经的关系分为四种关系:1压迫关系:神经和血管的接触部位有血管压迹,血管对其受压偏移;2接触关系:神经和邻近的血管之间最短距离为0;3邻近关系:神经和邻近的血管之间最短距离在0-1mm之间;4远离关系:神经和邻近的血管之间最短距离在1mm以上。5面听神经根与周围血管的关系,在原始图像及重组图像上观察邻近血管与同侧面听神经根长轴的最短距离处相应血管相对于神经根的方位(分上、下、内、外四个方位)。结果:1左右两侧面神经长度分别为2.0160±0.11647cm、2.0197±0.12807cm,左右听神经长度分别为1.9815±0.18884cm、1.9762±0.19072cm。面、听神经长度分别在左右侧之间无统计学差异(P=0.643、P=0.087)。2面听神经脑池-内耳道段血管袢与神经关系分型中Ⅰ型最多,左右两侧分别占61.9%、56.2%,其次为Ⅱ型较多,左右两侧分别占25.7%、30.5%,Ⅲ型最少,左右两侧分别占12.4%、13.3%;各型所占比例分别在左右两侧之间无统计学差异(P=0.687)。3双侧面听神经血管袢与神经关系分型中,在Ⅰ型中远离关系所占比例最大,右侧面神经、听神经分别占49.2%、54.2%,左侧面神经、听神经分别占43.1%、47.7%;Ⅲ型中接触关系所占比例最大,右侧面神经、听神经分别占64.3%、57.2%,左侧面神经、听神经分别占61.5%、53.8%;Ⅱ型介于Ⅰ型和Ⅲ型之间,在所有志愿者中,未发现血管与神经之间存在压迫关系的病例。4邻近血管与同侧面听神经根长轴的最短距离处相应血管相对于神经根的方位中,上方所占比例最多,占41.4%,其次为内侧和外侧较多,所占比例分别为32.9%、19.0%,下方所占比例最小,占6.7%。结论:1面、听神经长度分别在左右侧之间无统计学差异。2面听神经脑池-内耳道段血管袢与神经关系分型中Ⅰ型最多,Ⅲ型最少,各型所占比例分别在左右两侧之间无统计学差异。3血管与神经伴行距离越长,发生接触关系的几率越大。4邻近血管与同侧面听神经根长轴的最短距离处相应血管相对于神经根的方位中上、内方最多,下方最少。
[Abstract]:Objective: MRI has very high resolution, can clearly show the brain pool - inner ear segment of the facial nerve and adjacent vessels for action audiory diagnosis related nerve and the surrounding vessels has ideal. The subject of the use of the ear canal and around 3.0MR of normal human facial nerve cisternal in anatomy study, including the measurement of the surface to data structure and function of nerve itself and imaging, and audiory nerve and peripheral vascular anatomy relationship breakdown, and audiory nerve related diseases clinical diagnosis basis. Methods: 1 healthy volunteers received 105 cases, volunteers record basic information such as age, gender, the clinical symptoms and signs, and eliminate head surgery facial nerve caused by hemifacial spasm, nerve deafness and other symptoms in our hospital of MR T2FLAIR, 3D-TOF sequence and 3D-FIESTA sequence. And check by conventional T2FLAIR image In addition to volunteers, cerebral infarction, intracranial tumor, brain stem, cerebellopontine angle lesions, petrous bone deformity and other diseases, 3D-FIESTA image sequence for the facial nerve reconstruction and measurement of.3D-TOF sequence is used to distinguish the facial nerve around the arteriovenous.2 using 3D-FIESTA sequence of crown image, sagittal reconstruction, carefully observe the nerve walk the line, thickness, morphology, measurement of facial nerve cisternal - inner ear length, and statistics were on both sides of the facial nerve length difference of.3 - cisternal canal segment in the inner ear section has no blood vessels and vascular loops into the depth is divided into three types type I: canal segment, there is no vascular loop; type II, vascular loop in the inner ear, but lack of depth in the inner ear blood vessels into the depth of 50%; type III, as the canal segment vascular loops, and enter the depth over canal segment depth 50%.4 Zi Fine observation on adjacent blood vessels and nerves from the nearest part of the measurement of blood vessels and nerves in the distance, according to the measurement of the distance relationship between blood vessels and nerves are divided into four kinds of relationship: 1 compression relationship: contact part of the nerves and blood vessels with vascular compression, the compression of vascular migration; 2 Contact: relationship between the nerve and the the adjacent blood vessels and the shortest distance is 0; 3 adjacent relationship between the nerve and adjacent vessels: the shortest distance between 0-1mm; 4 from the relationship between the nerve and adjacent blood vessels: the shortest distance of over 1mm.5 to nerve roots and peripheral vascular and adjacent blood vessels with the same side to observe nerve root axis the shortest distance between the original image and the image corresponding to the recombinant vascular nerve root orientation (points, and in the four directions). Results: 1 of two facial nerve length were 2.0160 + 0.11647cm, 2.0197 + 0.12807cm, long around the auditory nerve Were 1.9815 + 0.18884cm, 1.9762 + 0.19072cm., the auditory nerve length on the left side were no significant difference between (P=0.643, P=0.087).2 of the facial nerve canal segment - cisternal vascular loops and neural relationship between type I type in the most left and right sides respectively 61.9%, 56.2%, followed by type II more. The left and right sides respectively 25.7%, 30.5%, type III at the left and right sides are respectively accounted for 12.4% and 13.3%; the proportion in the left and right sides were no significant difference between (P=0.687).3 double side of the auditory nerve and nerve vascular loop type relationship, away from the relationship in the type I in the largest proportion of the right facial nerve the auditory nerve, respectively 49.2%, 54.2%, left facial nerve and auditory nerve accounted for 43.1%, 47.7%; contact type III in the largest proportion of the right facial nerve, acoustic nerve accounted for 64.3%, 57.2%, left facial nerve and auditory nerve accounted for 61.5%, 53.8%; type II is 1 Between type I and type III, in all the volunteers, found no cases of vascular compression.4 adjacent relationship between vessels and nerves and nerve root of the long axis of the same side to the shortest distance relative to the corresponding vascular nerve root range, above the largest proportion, accounting for 41.4%, followed by the inside and outside more, accounted for the ratio was 32.9%, 19%, below the minimum proportion, accounting for 6.7%. conclusions: 1, the auditory nerve length on the left side were no significant difference between the.2 facial nerve canal segment - cisternal vascular loops and neural relationship between type I type III most, at least, the proportion in the both sides have no significant difference between.3 and vascular nerve accompanying the longer distance, the greater the probability of contact between.4 and adjacent blood vessels with facial acoustic nerve root long axis is the shortest distance relative to the corresponding vascular nerve root orientation, inside the most, The bottom is the least.

【学位授予单位】：河北医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R445.2

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