【摘要】 目的 探讨三维稳态进动快速成像序列(3D-FIESTA)结合三维时间飞跃法血管造影(3D-TOF MRA)在颅神经微血管减压术前评估中的应用价值。方法 回顾性分析我院26例行微血管减压术手术治疗的原发性三叉神经痛或面肌痉挛患者临床资料,所有患者术前均接受MRI检查(包括3D-FIESTA和3D-TOFMRA),寻找判定责任血管,以指导手术治疗。结果 本组26例患者中术前检查均认定有责任血管,单纯性动脉23例,其中4例发自小脑上动脉,13例发自小脑前下动脉,6例发自小脑后下动脉,动静脉混合2例,单纯静脉1例。术中证实都存在相应的责任血管压迫颅神经,但1例原发性三叉神经痛患者,术前责任血管认定为小脑前下动脉压迫,术中发现同时有静脉血管接触。所有患者术后均恢复良好。结论 联合使用3D-TOFMRA和3D-FIESTA扫描序列可明显提高责任血管的判定率,尤其有利于动静脉血管的鉴别,同时能够显示神经血管的局部解剖关系,利于指导手术设计。更多还原

【Abstract】 Objective To explore the value of three-dimensional fast imaging with steady-state acquisition(3D-FIESTA) combining three-dimensional time-of-flight(3D-TOF) magnetic resonance angiography(MRA) in the preoperative evaluation of microvascular decompression for cranial nerve.Methods The clinical data of 26 cases of trigeminal neuralgia or hemifacial spasm who underwent microvascular decompression were retrospectively analysed.All patients preoperatively underwent MRI examination(3D-FIESTA and 3D-TOF MRA)for the responsible vessels and guidance.Results The responsible vessels were found in the preoperative examination and confirmed during the operation in all cases.There were 23 cases of simple artery,including superior cerebellar artery in 4 cases,anterior inferior cerebellar artery in 13 cases and posterior inferior cerebellar artery in 6 cases.The mixture of artery and vein was found in 2 cases and simple vein in 1 case.But in one case of TN,the preoperative responsible blood vessels identified as the anterior inferior cerebellar artery,while another venous access was found during the operation.All patients recovered uneventfully.Conclusion The combining use of 3D-TOF MRA and 3D-FIESTA can significantly improve the detection rate of responsible vessels.It is especially useful in the identification of arteries and veins,and can display the anatomy relationship of nerves and vessels,which will help to guide the surgical design.更多还原