血管压迫性面肌痉挛的磁共振断层血管成像表现及其诊断价值

发布时间：2018-05-15 05:34

本文选题：面肌痉挛 + 磁共振断层血管成像　；参考：《第三军医大学学报》2015年12期

【摘要】：目的评价磁共振断层血管成像(magnetic resonance tomographic angiography,MRTA)显示面神经与周围血管三维空间关系的能力,探讨MRTA对血管压迫性面肌痉挛(hemifacial spasm,HFS)的诊断价值。方法回顾分析210例HFS患者临床及MR资料,并与手术结果进行对照。结果 210例HFS患者,MRTA显示患侧(共215侧,双侧症状5例)有血管压迫和接触面神经分别109侧和86侧,可疑接触9侧,阳性率为94.9%;健侧(205侧)面神经有血管压迫和接触分别12侧和23侧,可疑接触6侧,阳性率为20%。HFS患者患侧与健侧面神经与邻近血管解剖关系上,差异有统计学意义,其症状与血管接触或压迫面神经有显著相关性(P0.01)。80例手术患者术中见78例有血管压迫或接触,未见责任血管2例;71例术前MRTA与术中所见完全相符,4例术前MRTA阴性患者,术中3例见静脉责任血管。以手术结果为金标准,MRTA诊断HFS的灵敏度为96.2%,诊断符合率95.0%。结论MRTA是术前诊断HFS病因无创、有效的检查方法,能清楚显示面神经与周围血管的空间关系,为HFS的诊治提供可靠的影像学依据。
[Abstract]:Objective to evaluate the ability of magnetic resonance tomography (resonance tomographic) to display the three-dimensional spatial relationship between facial nerve and peripheral blood vessels, and to evaluate the diagnostic value of MRTA in hemifacial spasms. Methods the clinical and Mr data of 210 patients with HFS were retrospectively analyzed and compared with the operative results. Results in 210 patients with HFS, HFS showed that the affected side (215 sides, 5 bilateral symptoms) had vascular compression and contact with facial nerve in 109 and 86 sides, and suspected contact in 9 sides, respectively. The positive rate of facial nerve was 94.9. The facial nerve had vascular compression and contact in 12 and 23 sides, respectively, and suspected contact in 6 sides. The positive rate was the anatomic relationship between the affected and healthy facial nerves and adjacent vessels in patients with 20%.HFS, and the difference was statistically significant. There was a significant correlation between the symptoms and vascular contact or compression of facial nerve. 78 cases were found to have vascular compression or contact during operation in 80 cases, and 71 cases of MRTA were not found in 2 cases. The results of preoperative MRTA were in good agreement with those of 4 cases with negative MRTA during operation. The responsible vein vessels were found in 3 cases during operation. The sensitivity of MRTA in the diagnosis of HFS was 96. 2 and the diagnostic coincidence rate was 95. 0%. Conclusion MRTA is a noninvasive and effective method for the diagnosis of HFS before operation. It can clearly show the spatial relationship between facial nerve and peripheral blood vessels and provide reliable imaging basis for the diagnosis and treatment of HFS.
【作者单位】：第三军医大学新桥医院放射科;
【分类号】：R745.12;R445.2

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