汪倩倩,曾少华,洪桂洵,饶良俊,初建平,杨智云.三维可变翻转角快速自旋回波序列术前评估听神经瘤[J].中国医学影像技术,2018,34(6):841~845
三维可变翻转角快速自旋回波序列术前评估听神经瘤
Three-dimensional sampling perfection with application optimized contrasts using different flip angle evolutions sequence in preoperative evaluation of acoustic neuroma
投稿时间:2017-12-17  修订日期:2018-04-04
DOI:10.13929/j.1003-3289.201712086
中文关键词:  神经瘤,听  脑神经  磁共振成像
英文关键词:Neuroma, acoustic  Cranial nerve  Magnetic resonance imaging
基金项目:
作者单位E-mail
汪倩倩 台山市人民医院医学影像科, 广东 台山 529200  
曾少华 清远市人民医院医学影像科, 广东 清远 511518  
洪桂洵 中山大学附属第一医院医学影像科, 广东 广州 510080  
饶良俊 中山大学附属第一医院医学影像科, 广东 广州 510080  
初建平 中山大学附属第一医院医学影像科, 广东 广州 510080  
杨智云 中山大学附属第一医院医学影像科, 广东 广州 510080 cjr.yangzhiyun@vip.163.com 
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中文摘要:
      目的 探讨3.0T MR三维时间飞跃(3D-TOF)与三维稳态采集快速成像(3D-FIESTA)序列融合图像在三叉神经及面神经显微血管减压术(MVD)术前评估三叉神经、面神经与邻近血管关系的价值。方法 回顾性分析经MVD治疗的36例三叉神经痛(TN)及31例面肌痉挛(HFS)患者的影像学资料。分析2名医师评判三叉神经、面神经与邻近血管关系的一致性,分别比较TN及HFS症状侧及无症状侧神经血管压迫(NVC)征象出现率的差异;以手术结果为金标准,计算3D-TOF与3D-FIESTA序列融合图像对症状侧神经与血管关系的诊断效能。结果 2名医师评价症状侧及无症状侧三叉神经及面神经与血管关系的一致性均好(P均<0.001)。TN及HFS患者症状侧NVC征象出现率均明显高于无症状侧(χ2=26.13、20.81,P均<0.001)。3D-TOF与3D-FIESTA序列融合图像诊断三叉神经与血管关系的准确率、敏感度、特异度、阳性预测值和阴性预测值分别为97.22%(35/36)、97.06%(33/34)、100%(2/2)、100%(33/33)和66.67%(2/3);诊断面神经与血管关系的准确率、敏感度、特异度、阳性预测值和阴性预测值分别为93.55%(29/31)、96.55%(28/29)、50.00%(1/2)、96.55%(28/29)和50.00%(1/2)。结论 3D-TOF与3D-FIESTA序列融合图像能清晰显示神经与血管的空间关系,可为MVD提供可靠的影像学依据。
英文摘要:
      Objective To investigate the clinical value of three-dimensional sampling perfection with application optimized contrasts using different flip angle evolutions (3D-SPACE) sequence in preoperative evaluation of acoustic neuroma. Methods Totally 57 patients with acoustic neuroma confirmed by surgery and pathology were enrolled. All patients underwent preoperative routine head MR and 3D-SPACE sequence. The position, size and shape of the tumors were observed, and the display rate of surrounding cranial nerves was evaluated with 3D-SPACE sequence. The results were compared with those of conventional MRI and operation. Results All 57 patients were found with single tumor. The tumor in 1 patient (1/57, 1.75%) limited in the internal auditory canal, and those in another 56 patients (56/57, 98.25%) exceed the internal auditory canal crossing growth. The inner auditory canal fundus in 26 patients (26/57, 45.61%) were completely filled by the tumors, while those in another 31 patients (31/57) were uncompletely filled. 3D-SPACE sequence showed 21 patients (21/57, 36.84%) with solid type lesions, 35 patients (61.40%, 35/57) with solid with cystic type lesions and 1 patient (1/57, 1.76%) with cystic type lesion. The coincidence rate of lesion types showed with 3D-SPACE sequence and intraoperative findings was 85.96% (49/57). The display rate of trigeminal nerve internal cisternal segment, lower cranial nerves cisternal segment, abducens nerve cisternal segment, facial nerve internal acoustic meatus segment, facial nerve cisternal segment and acoustic nerve cisternal segment was 100% (57/57), 100%(57/57), 75.44% (43/57), 50.88% (29/57), 17.53% (10/57) and 19.30% (11/57), respectively, all significantly increased compared with those of conventional MRI (all P<0.05). Conclusion 3D-SPACE sequence can accurately display the relationship between tumor and adjacent cranial nerves, therefore has important clinical value in preoperative evaluation of acoustic neuroma.
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