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目的探讨三叉神经痛患者三叉神经血管压迫的MRI表现及其诊断价值。方法利用磁共振三维时间飞跃(3D-TOF)序列成像技术及图像后处理技术,对58例三叉神经痛患者的MRI表现及手术结果进行回顾性分析。结果(1)58例患者MRI显示症状侧存在责任血管压迫三叉神经49例,桥小脑角肿瘤3例(均由手术证实)。手术发现责任血管压迫三叉神经54例。(2)根据手术结果,MRI诊断三叉神经痛的敏感度和特异度分别为89.7%(52/58)和90.9%(50/55)。6例阴性患者术中5例发现责任血管压迫,阴性符合率为16.7%(1/6)。结论血管压迫三叉神经出脑干段是三叉神经痛的主要病因,3D-TOF成像能清晰显示三叉神经与周围结构的解剖关系,有助于病因诊断、术前评估及指导术中对责任血管的来源及其走向的把握。
Objective To investigate the MRI findings and the diagnostic value of trigeminal neural vascular compression in patients with trigeminal neuralgia. Methods Magnetic resonance 3D time-of-flight (3D-TOF) sequence imaging and image postprocessing were used to analyze the MRI findings and surgical findings of 58 trigeminal neuralgia patients. Results (1) Fifty-eight patients showed symptomatic MRI with 49 cases of vascular compression trigeminal nerve and 3 cases of cerebellopontine angle tumor confirmed by surgery. Surgical discovery of responsible vascular compression of the trigeminal nerve in 54 cases. (2) According to the results of surgery, the sensitivity and specificity of MRI in diagnosing trigeminal neuralgia were 89.7% (52/58) and 90.9% (50/55) respectively. In 6 cases of negative patients, 5 cases were found to have responsible vascular compression, the negative coincidence rate was 16.7% (1/6). Conclusions The main cause of trigeminal neuralgia is vascular compression of the trigeminal nerve. 3D-TOF imaging can clearly show the anatomical relationship between the trigeminal nerve and the surrounding structures, which is helpful for the diagnosis of etiology, preoperative evaluation and guidance on the management of responsible vessels Source and grasp of its direction.