【摘要】 目的术前应用颅底3DCT重建图像测量卵圆孔(Foramen Oval,FO),分析数据并评估其对三叉神经射频热凝手术难易程度的影响。方法选取2012年5月至2016年3月于吉林大学中日联谊医院神经外科接受射频热凝治疗的共31例原发三叉神经痛病例,术前行颅底3DCT重建并于轴位及穿刺位图像上测量卵圆孔的横径、纵径,计算卵圆孔的面积。分析测量结果并与实际手术穿刺次数进行比较。结果本组病例卵圆孔的轴位及穿刺位的最大横径数值比较,无显著性差异(P>0.05),最大纵径数值比较有显著性差异(P<0.001),且穿刺位最大纵径小于轴位最大纵径。卵圆孔最大横径<6.0 mm的有18例,手术穿刺次数与最大横径>6.0 mm者比较有显著差异(P<0.001),且卵圆孔最大横径<6.0mm者手术穿刺次数高于最大横径>6.0mm者。卵圆孔最大纵径<3.2mm有20例,手术穿刺次数与最大纵径>3.2mm者比较有显著差异(P<0.05),且卵圆孔最大纵径<3.2mm者手术穿刺次数高于最大纵径>3.2mm者。解剖面积<15.0mm~2有16例,手术穿刺次数明显增加。结论术前应用3DCT重建图像测量FO可以提示三叉神经射频热凝手术的难度,指导手术方式的选择。更多还原

【Abstract】 Objective Use preoperative 3 DCT reconstructed image of skull base to measure foramen oval,analyze the data of FO and assess the difficulty of percutaneous radiofrequency thermocoagulation for trigeminal neuralgia according to the data.Methods This study included 31 cases who have accepted operation of percutaneous radiofrequency thermocoagulation through foramen ovale on Gasserian Ganglion in the department of neurosurgery of China-Japen Union Hospital of Jilin University from May 2012 to March 2016.3 DCT Reconstrucion image was made before surgery,transverse and anterior-posterior diameter and area of FO was measured on axial CT image and 3 Dreconstructed image in the direction of the trajectory.Analyze the data and correlation with number of times of puncture.Results In this study,the axial largest transverse diameter and largest transverse diameter measured in direction of the trajectory of FO had no significant differences(P>0.05).The axial largest anterior-posterior diameter and largest anterior-posterior diameter measured in direction of the trajectory of FO had significant differences(P<0.001),and the data measured in direction of the trajectory is smaller than the data measured on axial CT image.There were 18 cases with the largest transverse diameter of FO<6.0 mm and the number of times of puncture was more than those cases with the largest transverse diameter of FO>6.0 mm(P<0.001).Also,20 cases with the largest anterior-posterior diameter of FO<3.2 mm had more times of puncture than those with anterior-posterior diameter of FO>3.2 mm(P<0.05).There are 16 cases with anatomical area less than 15.0 mm~2 and with more puncture times.Conclusion Measuring FO using preoperative 3 DCT reconstructed image can assess the difficulty of percutaneous radiofrequency thermocoagulation for trigeminal neuralgia and method of operation.更多还原