磁共振3D-TOF联合3D-FIESTA对原发性三叉神经痛的价值研究

发布时间：2019-06-25 13:03

【摘要】：目的：采用3.0TMR3D-TOF及3D-FIESTA序列检测三叉神经及周围血管关系,探讨责任血管构成,责任血管与三叉神经关系及易诱发三叉神经痛的血管类型。方法：回顾分析105例三叉神经痛患者及80例非三叉神经痛患者3D-TOF及3D-FIESTA序列磁共振图像。取三叉神经痛患者患侧为病例组,健侧及非三叉神经痛患者双侧为对照组,主要针对三叉神经根部,观察三叉神经与周围血管关系,责任血管组成,易发病血管类型。将三叉神经与周围血管之间关系分为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： 105例三叉神经痛患者及80例非三叉神经痛患者共370侧,其中病例组106侧(1例为双侧发病),压迫27侧,占病例组25.5%,接触53侧,占病例组50.0%,对照组中三叉神经痛健侧组104侧,压迫0例,接触16例,占三叉神经痛健侧组的15.4%,非三叉神经痛组160侧,压迫0例,接触26例,占非三叉神经痛组的16.3%。经统计学分析,对照组中三叉神经痛健侧组与非三叉神经痛组双侧血管构成无显著差异,病例组与对照组(包括三叉神经痛患者健侧及非三叉神经痛患者两侧)差异有显著意义(P0.05)。所有责任血管构成比例,小脑上动脉(SCA)占71.25%,小脑前下动脉(AICA)占20.0%,基底动脉(BA)占2.5%,两支血管联合占5.0%,静脉占1.25%。结论：磁共振3D-TOF联合3D-FIESTA序列能清晰显示三叉神经及毗邻结构关系,特别是血管与三叉神经关系；三叉神经痛责任血管主要有SCA,AICA,BA;血管压迫是三叉神经痛的重要病因。
[Abstract]:Objective: to detect the relationship between trigeminal nerve and peripheral blood vessels by 3.0TMR3D-TOF and 3D-FIESTA sequences, and to explore the composition of responsible vessels, the relationship between responsible vessels and trigeminal nerves, and the types of blood vessels that are easy to induce trigeminal neuralgia. Methods: the 3D-TOF and 3D-FIESTA sequence magnetic resonance images of 105 patients with trigeminal neuralgia and 80 patients with non-trigeminal neuralgia were analyzed retrospectively. The affected side of trigeminal Neuralgia was taken as the case group, and the healthy side and bilateral side of non-trigeminal Neuralgia as control group. The relationship between trigeminal nerve and peripheral blood vessels, the composition of responsible blood vessels and the types of blood vessels were observed. The relationship between trigeminal nerve and peripheral blood vessels was divided into 5 types. Type 1 was non-vascular, type 2 was far away, type 3 was close, type 4 contact, type 5 compression, of which type 4, type 5 were positive, type 1, type 2 and type 3 were negative. Results: there were 370 sides of 105 patients with trigeminal neuralgia and 80 patients with non-trigeminal neuralgia, including 106 sides of case group (1 case of bilateral onset), 27 sides of compression (25.5%), 53 sides of contact (50.0%), 104 sides of healthy side of trigeminal neuralgia group, 0 cases of compression, 16 cases of contact, accounting for 15.4% of the healthy group of trigeminal neuralgia, 160 sides of non-trigeminal neuralgia group and 0 cases of compression. 26 cases were exposed, accounting for 16.3% of the non-trigeminal neuralgia group. Statistical analysis showed that there was no significant difference in bilateral vascular composition between the healthy side group and the non-trigeminal neuralgia group, but there was significant difference between the case group and the control group (including the healthy side and the two sides of the non-trigeminal neuralgia group) (P 0.05). The proportion of all responsible vessels was 72.5% in superior cerebellar artery, 20.0% in anterior inferior cerebellar artery, 2.5% in basilar artery, 5.0% in combination of two vessels and 1.25% in vein. Conclusion: magnetic resonance 3D-TOF combined with 3D-FIESTA sequence can clearly show the relationship between trigeminal nerve and its adjacent structure, especially the relationship between blood vessel and trigeminal nerve, and SCA,AICA,BA; vascular compression is an important cause of trigeminal neuralgia.
【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】：R745.11

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