内听道3D-磁共振成像薄层扫描后颅窝内相关解剖学指标与原发性三叉神经痛的关系研究

发布时间：2019-06-04 08:22

【摘要】：目的探讨内听道3D-磁共振成像(MRI)薄层扫描后颅窝内相关解剖学指标与原发性三叉神经痛(PTN)发病及行微血管减压术(MVD)治疗预后的关系。方法选择2013年3月—2015年3月新疆医科大学第一附属医院神经外科收治的符合纳入与排除标准的PTN患者63例为病例组,同时匹配性别、年龄、民族收集同时期本院体检中心自愿接受MRI检查的体检健康者20例为对照组,术前均行颅脑MRI平扫及内听道3D-MRI薄层扫描,观察后颅窝内桥小脑角(CPA)容积、三叉神经根体积、三叉神经根横截面积、三叉神经根长度等相关解剖学指标,PTN患者均行MVD治疗,根据预后分为有效组50例和无效组13例,分析一般资料及后颅窝内相关解剖学指标与MVD治疗预后的关系。结果对照组受试者左侧与右侧CPA容积、三叉神经根体积、三叉神经根横截面积、三叉神经根长度比较,差异均无统计学意义(P0.05)。PTN患者患侧CPA容积、三叉神经根体积、三叉神经根横截面积小于健侧(P0.05);健侧与患侧三叉神经根长度比较,差异无统计学意义(P0.05)。有效组与无效组PTN患者性别、年龄、民族、病变侧别、累及三叉神经分支、三叉神经根长度比较,差异均无统计学意义(P0.05);有效组与无效组PTN患者病程、责任血管、血管与神经关系、CPA容积、三叉神经根体积、三叉神经根横截面积比较,差异均有统计学意义(P0.05)。结论 CPA容积减小、三叉神经根萎缩并体积及横截面积变小是PTN产生的原因。病程长、责任血管为静脉、血管与神经有明确压迫关系、CPA容积小、三叉神经根萎缩并体积及横截面积小的PTN患者行MVD治疗后预后较其他患者差。
[Abstract]:Objective to investigate the relationship between anatomical indexes in fossa after 3D-magnetic resonance imaging (MRI) of internal auditory canal and prognosis of primary trigeminal neuralgia (PTN) and microvascular decompression (MVD). Methods 63 PTN patients admitted to the first affiliated Hospital of Xinjiang Medical University from March 2013 to March 2015 were selected as the case group, matching sex and age. Twenty healthy persons who volunteered to be examined by MRI in the physical examination center of our hospital at the same time were collected as the control group. The (CPA) volume of cerebellopontine angle in the posterior fossa was observed by plain scan of MRI and thin slice scan of internal auditory canal before operation. The patients with PTN were treated with MVD according to the volume of trigeminal nerve root, the cross section area of trigeminal nerve root and the length of trigeminal nerve root. According to the prognosis, they were divided into effective group (n = 50) and ineffective group (n = 13). The relationship between general data and anatomical indexes in posterior fossa and prognosis of MVD was analyzed. Results there were no significant differences in left and right CPA volume, trigeminal root cross section area and trigeminal nerve root length between the two groups (P 0.05). CPA volume and trigeminal root volume in patients with PTN, The cross section area of trigeminal nerve root was smaller than that of healthy side (P 0.05). There was no significant difference in the length of trigeminal nerve root between the healthy side and the affected side (P 0.05). There was no significant difference in sex, age, nationality, lesion side, involving trigeminal nerve branches and trigeminal nerve root length between the effective group and the ineffective group (P 0.05). There were significant differences in the course of disease, responsible blood vessels, relationship between blood vessels and nerves, CPA volume, trigeminal nerve root volume and cross section area of trigeminal nerve root between effective group and ineffective group (P 0.05). Conclusion the decrease of CPA volume, the atrophy of trigeminal nerve root and the decrease of cross section area are the causes of PTN. The prognosis of PTN patients with long course of disease, the responsible vessels were veins, and there was a clear compression relationship between blood vessels and nerves. The prognosis of PTN patients with small CPA volume, trigeminal nerve root atrophy and small volume and cross section area was worse than that of other patients after MVD treatment.
【作者单位】：新疆医科大学第一附属医院神经外科;
【基金】：新疆维吾尔自治区自然科学基金资助项目(2014211C053)
【分类号】：R445.2;R745.11

【相似文献】