【摘要】 目的 对比分析三维时间飞跃法核磁共振血管成像(3D-TOF MRA)应用于三叉神经痛患者微血管压迫诊断及血管压迫情况与程度判断中的价值。方法 回顾性分析2014年1月至2016年1月间采用微血管减压术(MVD)治疗的49例原发性三叉神经痛病例资料,患者均于MVD术前行3D-TOFMRA成像分析,以明确是否存在微血管压迫、压迫的程度以及主要责任血管等详细情况;以MVD术中所见为确诊金标准,分析3D-TOFMRA成像对于三叉神经痛患者微血管压迫的诊断价值。结果 3D-TOFMRA成像诊断结果与MVD手术结果无显著性差异性(P>0.05)。3D-TOFMRA成像诊断准确率为89.80%,灵敏度为97.30%,特异度为66.67%,ROC曲线下面积为0.820。术前3D-TOF MRA诊断NVC发生率为63.27%,MVD术中所见NVC发生率为63.27%,术前3D-TOF MRA对于NVC程度的诊断结果与MVD术中所见无统计学意义(P>0.05)。术前D-TOF MRA成像诊断血管压迫中责任血管为动脉血管的发生率为89.80%,与MVD术中所见差异无显著性(P>0.05)。结论3D-TOFMRA成像诊断三叉神经痛微血管压迫准确性高,能够基本明确微血管压迫的具体位置关系、程度以及主要责任血管,对于临床诊断及MVD手术方案的制定均具有重要参考价值。更多还原

【Abstract】 Objective To evaluate the value of(3 D-TOF MRA) imaging in the diagnosis and evaluation of microvascular and the degree of vascular in patients with trigeminal neuralgia. Methods The data of 49 patients with primary trigeminal neuralgia treated by microvascular decompression(MVD) from January 2014 to January 2016 were retrospectively analyzed. All patients underwent 3 D-TOF before MVD MRA imaging were analyzed to determine whether there was microvascular compression, the degree of oppression and the main responsibility of blood vessels and other details. The diagnostic value of 3 D-TOF MRA imaging in microvascular compression of trigeminal neuralgia were evaluated with the standard of gold for diagnosis in MVD. Results There was no significant difference between 3 D-TOF MRA imaging and MVD(P>0.05). The accuracy of 3 D-TOF MRA imaging was 89.80%, the sensitivity was 97.30%, the specificity was 66.67%, and the area under the ROC curve was0.820. The incidence of NVC was 63.27% in preoperative 3 D-TOF MRA and 63.27% in MVD. The results of preoperative 3 D-TOF MRA for NVC were not statistically significant(P<0.05) Gt; 0.05). Preoperative 3 D-TOF MRA imaging in the diagnosis of vascular compression in the blood vessel for the incidence of arterial vessels was 89.80%, and MVD surgery showed significant sex difference( P>0.05). Conclusion The diagnosis accuracy of 3 D-TOF MRA imaging in trigeminal neuralgia microvascular compression is high, which can basically clear the specific relationship between microvascular pressure, degree and the main responsibility of blood vessels. It has important reference value for the clinical diagnosis and the formulation of MVD surgical procedures.更多还原