颅底薄层3D-TOF联合3D-FIESTA对偏侧面肌痉挛病因诊断研究

发布时间：2018-08-05 12:52

【摘要】：研究目的：采用3.0T MR3D-TOF及3D-FIESTA序列检测面神经及周围血管关系,探讨责任血管构成,责任血管与面神经关系及易诱发面肌痉挛的血管类型。方法：回顾分析163例偏侧面肌痉挛及107例非偏侧面肌痉挛3D-TOF及3D-FIESTA序列磁共振图像。偏侧面肌痉挛患者患侧为病例组,健侧及非偏侧面肌痉挛患者双侧为对照组,主要观察面神经根部,分析面神经与周围责任血管关系,责任血管组成,易发病血管类型。将面神经与责任血管之间关系分为5型。1型无血管,2型远离,3型接近,4型接触,5型压迫,其中4型,5型判为阳性,1型,2型,3型判为阴性。结果：163例偏侧面肌痉挛患者及107例非偏侧面肌痉挛患者共540侧,均清楚显示面神经根部及邻近结构,其中病例组166侧(3例为双侧发病),压迫29侧,占病例组17.5%,接触97侧,占病例组58.4%,对照组中偏侧面肌痉挛健侧组160侧,压迫0例,接触33例,占偏侧面肌痉挛健侧组的20.6%,非面肌痉挛组压迫0例,接触41例,占非面肌痉挛组的19.1%,经统计学分析,对照组偏侧面肌痉挛健侧组与非面肌痉挛组双侧血管构成无显著差异,病例组与对照组(包括偏侧面肌痉挛患者健侧及非偏侧面肌痉挛患者两侧)差异有显著意义(P0.05)。所有责任血管构成比例,AICA占38.9%,PICA占35.7%,单独VA占19.0%。椎动脉联合其他血管占4%。对所有病例组及对照组,椎动脉接触或压迫与PICA、AICA接触或压迫进行对比分析,发现27侧椎动脉接触或压迫中,24例发病,发病率：88.9%；71例PICA接触或压迫中45例发病,发病率63.4%；94例AICA接触或压迫中49例发病,发病率52.1%。结论：磁共振3D-TOF及3D-FIESTA序列能清晰显示面神经及毗邻结构关系,特别是血管与面神经关系；偏侧面肌痉挛责任血管主要有AICA, PICA, VA;血管压迫是偏侧面肌痉挛的重要病因；椎动脉压迫较PICA、AICA压迫更易发病。
[Abstract]:Objective: to investigate the relationship between facial nerve and peripheral blood vessels by using 3.0T MR3D-TOF and 3D-FIESTA sequences, and to explore the relationship between responsible blood vessels and facial nerves and the types of vessels that are prone to induce hemifacial spasm. Methods: 3D-TOF and 3D-FIESTA images of 163 cases of hemifacial spasm and 107 cases of non-hemifacial spasm were retrospectively analyzed. Patients with hemifacial spasm were treated with hemifacial spasm and those with contralateral and non-hemifacial spasm were treated as control group. The root of facial nerve was observed and the relationship between facial nerve and peripheral responsible blood vessels was analyzed. The relationship between the facial nerve and the responsible vessels was divided into type 5, type 1, no vessel, type 2, far away from type 3, close to type 4, contact type 5, type 4, type 1, type 2, type 3, type 3 were negative. Results 540 sides of 540 hemifacial spasm patients and 107 non-hemifacial spasm patients were found. The facial nerve roots and adjacent structures were clearly displayed in the case group. Among them, 166 sides in the case group (3 cases were bilateral disease), 29 sides were compressed, 17.5% of them were in the case group, 97 sides were in contact with each other. In the control group, there were 160 sides of hemifacial spasm, 0 cases of compression, 33 cases of contact, 20.6% of the contralateral group of hemifacial spasm, 0 cases of compression of non-hemifacial spasm group, 41 cases of contact with non-hemifacial spasm group, and 19.1% of non-hemifacial spasm group. There was no significant difference in bilateral vascular composition between hemifacial spasm group and non-hemifacial spasm group in control group, but there was significant difference between case group and control group (including both sides of hemifacial spasm group and non-hemifacial spasm group) (P0.05). The proportion of all responsible blood vessels was 38.9%, PICA was 35.7cm, VA was 19.0%. Vertebral artery combined with other blood vessels accounted for 4%. In all cases and control group, the vertebral artery contact or compression was compared with that of PICA AICA. It was found that 24 cases of vertebral artery contact or compression occurred in 27 sides, and 45 cases of 71 cases of PICA contact or compression with the incidence rate of 88.9% (63.4%). 49 out of 94 cases of AICA contact or compression, the incidence rate was 52.1%. Conclusion: MRI 3D-TOF and 3D-FIESTA sequences can clearly display the relationship between facial nerve and adjacent structures, especially the relationship between blood vessels and facial nerves, the main responsible vessels for hemifacial spasm are AICA, PICA, VA; vascular compression, which is an important cause of hemifacial spasm. Vertebral artery compression is more likely than PICA AICA compression.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R745.12

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