血管压迫性三叉神经痛责任血管的MR仿真内镜重建研究

发布时间：2018-03-13 09:03

本文选题：磁共振仿真内镜重建　切入点：微血管减压术　出处：《临床放射学杂志》2015年10期 　论文类型：期刊论文

【摘要】：目的探讨血管压迫性三叉神经痛的MR仿真内镜重建(MRVE)技术对责任血管的评估价值。方法对57例三叉神经痛患者采用双激发平衡式稳态自由进动序列(3D-FEISTA-C)扫描,经原始图像及MRVE分析判断责任血管与神经的关系,将45例与微血管减压术(MVD)结果比较对照,一致性检验采用Kappa分析,并计算出原始图像及运用MRVE技术在检测责任血管的敏感性、特异性、阳性预测值及阴性预测值。结果 57例采用3D-FIESTA-C联合MRVE显示血管神经无接触5例,接触13例,压迫39例;责任血管为小脑上动脉43例,岩静脉8例,椎基底动脉4例,小脑前下动脉2例;其中责任血管为两支者5例;接触及压迫部位发生于神经出脑干段45例,脑池段12例。57例中45例3D-FIESTA-C及联合MRVE显示血管神经接触及压迫、责任血管以及压迫部位与MVD术中所见一致性检验(K值分别为0.325、0.639)。运用3D-FIESTA-C及联合运用MRVE技术检测责任血管的敏感性分别为88.89%、97.78%,特异性分别为33.33%、58.33%,阳性预测值分别为85.11%、89.80%,阴性预测值分别50%、87.50%。结论运用MRVE技术能够为临床提供在一定空间范围内三维可视化图像,可作为术前评价重要的辅助工具。
[Abstract]:Objective to evaluate the value of Mr virtual endoscopic reconstruction (MRVEVEV) in the assessment of responsible vessels in patients with vascular compression trigeminal neuralgia. Methods 57 patients with trigeminal neuralgia were scanned by double excitation balanced steady-state free precession sequence 3D-FEISTA-C. The relationship between responsible vessels and nerves was judged by the original image and MRVE analysis. The results of 45 cases were compared with those of microvascular decompression. The consistency test was performed by Kappa analysis, and the sensitivity of the original image and MRVE technique in the detection of responsible vessels was calculated. Results in 57 cases, 3D-FIESTA-C combined with MRVE was used to display 5 cases of vascular and nerve contact, 13 cases of contact, 39 cases of compression, 43 cases of superior cerebellar artery, 8 cases of petrosal vein, 4 cases of vertebrobasilar artery, 43 cases of superior cerebellar artery, 8 cases of petrosal vein and 4 cases of vertebrobasilar artery. There were 2 cases of anterior inferior cerebellar artery, 5 cases of which the responsible vessels were two branches, 45 cases of contact and compression occurred in the brainstem segment of the nerve, 45 cases of 12 cases of cisternal segment, 45 cases of 3D-FIESTA-C and combined with MRVE to show the contact and compression of the vessels and nerves. The K values of the responsible vessels and the sites of compression and MVD were 0.325 ~ 0.639, respectively. The sensitivity of using 3D-FIESTA-C and the combined use of MRVE to detect the responsible blood vessels were 88.89 and 97.78, the specificity were 33.3333 and 58.33, the positive predictive values were 85.1189.80, and the negative ones were negative. Conclusion using MRVE technology can provide 3D visualization images in a certain space range for clinic. It can be used as an important assistant tool for preoperative evaluation.
【作者单位】：陕西省汉中市3201医院影像科;
【分类号】：R745.11;R445.2

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