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目的探讨MRI在椎基底动脉延长扩张症(VBD)引发颅底神经改变中的应用价值。方法搜集本院2012年3月至2015年1月期间经临床证实的VBD患者28例,男20例,女8例。所有患者均行脑MRA、MRI及3D-Fiesta-c序列扫描,VBD的纳入及分级标准分别参照Ubogu等提出的VBD的MRA半定量标准及Smoker的VBD的MRI分级标准。结果本组28例VBD中,1例脑干神经未见明显异常,余27例均伴有单侧一支或多支神经异常。其中22例单侧面神经受压,占81.48%;25例单侧发生移位,占92.59%;2例未见明显异常,占7.41%。15例单侧三叉神经受压,发生率占55.56%;24例单侧发生移位,占88.89%;3例未见明显异常,占11.11%。9例单侧舌咽神经受压,占33.33%;15例单侧发生移位,占55.57%;9例未见明显异常,占33.33%;3例一侧或双侧神经显示不清,占11.11%。8例单侧前庭蜗神经受压,发生率26.63%;25例单侧发生移位,占92.59%;2例未见明显异常,占7.41%。4例单侧外展神经受压,发生率14.81%;4例单侧发生移位,占14.81%;10例未见明显异常,占37.03%;12例一侧或双侧神经显示不清,占44.44%。结论 VBD对颅底神经的影响较大,脑MRI、MRA、3D-Fiesta-c序列相结合为VBD的诊断、颅底神经与延长扩张的椎基底动脉之间关系的显示提供有价值的影像学资料。
Objective To explore the value of MRI in the diagnosis of skull base nerve changes caused by vertebrobasilar prolongation (VBD). Methods We collected 28 clinically confirmed VBD patients from March 2012 to January 2015 in our hospital, including 20 males and 8 females. All patients underwent brain MRA, MRI and 3D-Fiesta-c sequence scan. The inclusion and grading standards of VBD were respectively referenced to MRA semi-quantitative standard of VBD and MRI grading standard of Smoker VBD proposed by Ubogu et al. Results In the 28 cases of VBD, no obvious abnormalities were found in one of the brainstem nerves and the other 27 cases were accompanied by unilateral or multiple nerve abnormalities. Among them, 22 cases of unilateral facial nerve compression, accounting for 81.48%; 25 cases unilateral displacement, accounting for 92.59%; 2 cases showed no significant abnormalities, accounting for 7.41%. 15 cases of unilateral trigeminal nerve compression, the incidence of 55.56%; 24 cases of unilateral shift, accounting for 88.89%; 3 cases showed no significant abnormalities, accounting for 11.11%. 9 cases of unilateral glossopharyngeal nerve compression, accounting for 33.33%; 15 cases of unilateral shift, accounting for 55.57%; 9 cases showed no significant abnormalities, accounting for 33.33%; 3 cases of unilateral or bilateral nerve showed unclear, accounting for 11.11%. 8 cases of unilateral vestibulocochlear nerve compression, the incidence rate of 26.63%; 25 cases unilateral displacement, accounting for 92.59%; 2 cases showed no significant abnormalities, accounting for 7.41%. 4 cases of unilateral abducens nerve compression, the incidence rate of 14.81%; 4 cases of unilateral shift, accounting for 14.81%; 10 cases showed no significant abnormalities, accounting for 37.03%; 12 cases of unilateral or bilateral nerve showed unclear, Accounting for 44.44%. Conclusion VBD has a great influence on the skull base nerve. The combination of MRI, MRA and 3D-Fiesta-c sequences provides a valuable diagnostic tool for the diagnosis of VBD. The visualization of the relationship between the skull base nerve and the dilated vertebrobasilar artery is valuable data.