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目的评价3D-COSMIC序列对三叉神经微血管压迫的诊断价值。方法 57例血管压迫性三叉神经痛患者术前均行3D-COSMIC序列图扫描,并与术后结果进行对照。结果 3D-COSMIC序列显示血管压迫的灵敏度、特异度和准确度分别为93.9%(46/49)、62.5%(5/8)、89.5%(51/57);神经血管关系:症状侧Ⅰ型2例(3.5%),Ⅱ型39例(68.4%),Ⅲ型16例(28.1%);无症状侧Ⅰ型23例(40.4%),Ⅱ型34例(59.6%),Ⅲ型0例,两侧压迫程度比较差异有统计学意义(P<0.05)。有血管神经压迫的神经,症状侧55例76处,近端压迫41处(53.9%),远端压迫35处(46.1%),无症状侧34例34处,其中近端压迫19处(55.9%),远端压迫15处(44.1%),症状侧与非症状侧压迫点位置比较差异无统计学意义(P>0.05)。结论 3D-COSMIC序列可以准确显示三叉神经与血管关系,有利于指导手术治疗。
Objective To evaluate the value of 3D-COSMIC in the diagnosis of trigeminal microvascular compression. Methods Fifty-seven patients with vascular compression trigeminal neuralgia were scanned with 3D-COSMIC sequence before surgery and compared with postoperative results. Results The sensitivity, specificity and accuracy of 3D-COSMIC were 93.9% (46/49), 62.5% (5/8) and 89.5% (51/57) respectively. The neurovascular relationship was type Ⅰ 2 cases (3.5%), 39 cases (68.4%) of type Ⅱ, 16 cases (28.1%) of type Ⅲ, 23 cases (40.4%) of type Ⅰ asymptomatic, 34 cases (Ⅱ) There was significant difference in compression between the two sides (P <0.05). Nerves with angio-nerve compression showed symptoms in 55 cases, 76 lesions, 41 proximal compression (53.9%), distal compression 35 (46.1%), 34 asymptomatic lesions 34 (proximal compression 19, 55.9 %), Distal compression of 15 (44.1%), the symptoms and non-symptomatic compression point location was no significant difference (P> 0.05). Conclusion 3D-COSMIC sequence can accurately show the relationship between the trigeminal nerve and blood vessels, which is conducive to guiding the surgical treatment.