| 罗星,邓浩,杨汉丰.原发性三叉神经痛患者神经血管压迫特征及其周围结构变化[J].中国医学影像技术,2022,38(11):1621~1625 |
| 原发性三叉神经痛患者神经血管压迫特征及其周围结构变化 |
| Neurovascular compression characteristics and surrounding structural changes in patients with primary trigeminal neuralgia |
| 投稿时间：2022-03-30 修订日期：2022-05-03 |
| DOI：10.13929/j.issn.1003-3289.2022.11.006 |
| 中文关键词: 三叉神经痛 磁共振成像 神经血管压迫 |
| 英文关键词:trigeminal neuralgia magnetic resonance imaging neurovascular compression |
| 基金项目:南充市校合作专项资金项目（19SXHZ0446）。 |
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| 中文摘要: |
| 目的 观察原发性三叉神经痛（TN）患者神经血管压迫（NVC）特征，定量分析三叉神经周围结构改变。方法 回顾性分析30例临床诊断TN （TN组）及30例存在眩晕或听力减退等症状但无三叉神经痛相关症状患者或健康体检者（对照组）的头部梯度回波-平衡式稳态自由进动序列图像和三维-时间飞跃-MR血管成像，观察TN组双侧三叉神经NVC表现，定量分析组间双侧三叉神经根入脑干区（REZ）之间距离及双侧REZ与小脑上动脉（SCA）起点高度差的差异。结果 TN组26例存在NVC，包括25例患侧（15例患侧、10例双侧）及1例对侧NVC；其中21例可见动脉NVC （12例患侧、8例双侧及1例对侧），13例可见静脉NVC （10例患侧、2例双侧及1例对侧），8例同时存在动、静脉NVC （6例患侧、1例双侧及1例患侧动脉NVC+对侧静脉NVC）；21例共29条三叉神经存在动脉NVC，包括24条SCA、6条小脑前下动脉（AICA）、2条椎动脉（VA）及1条小脑后下动脉（PICA） NVC；13例15条三叉神经存在静脉NVC，压迫血管均为岩上静脉系统（SPVS）。TN组与对照组双侧REZ间距分别为（3.48±0.17） cm及（3.38±0.16） cm，双侧REZ与SCA起点高度差分别为（1.22±0.30） cm及（1.40±0.26） cm，组间差异均有统计学意义（t=－2.242、2.482，P=0.029、0.016）。结论 TN患者NVC表现为双侧REZ距离增大、双侧REZ与SCA起点高度差缩小。 |
| 英文摘要: |
| Objective To observe the characteristics of neurovascular compression (NVC) in patients with primary trigeminal neuralgia (TN), and to quantitatively analyze the surrounding structural changes of trigeminal nerve. Methods Head gradient echo-balance steady state free precession sequence images and three dimensional-time of flight-MR angiography of 30 clinically diagnosed TN patients (TN group), as well as those of 23 patients with vertigo or hearing loss but without TN-related symptoms and 7 healthy subjects (control group) were retrospectively analyzed. NVC of bilateral trigeminal nerves in TN group were observed, the distance between bilateral trigeminal nerve root entry zone (REZ) and the height difference between bilateral REZ and the origin of superior cerebellar artery (SCA) were quantitatively analyzed and compared between groups. Results In TN group, 26 patients were found with NVC, including 25 on the affected side (15 on affected side and 10 on bilateral sides) and 1 on the contralateral side. Among 26 cases with NVC, arterial NVC was detected in 21 cases (12 on affected side, 8 on bilateral and 1 on contralateral side), while venous NVC was found in 13 cases (10 on affected side, 2 on bilateral and 1 on contralateral side). Eight cases were found with both arterial and venous NVC (6 on the affected side, 1 on bilateral sides and 1 arterial NVC+contralateral venous NVC on the affected side). Twenty-nine trigeminal nerves were found with arterial NVC in 21 patients, 24 with SCA, 6 with anterior inferior cerebellar artery (AICA), 2 with vertebral artery (VA) and 1 with posterior inferior cerebellar artery (PICA) compression. Thirteen patients had 15 trigeminal nerves with venous NVC from superior petrosal venous system (SPVS). The distance between bilateral trigeminal nerve REZ in TN group and control group was (3.48±0.17) cm and (3.38±0.16) cm, while the height difference between bilateral REZ and the origin of SCA was (1.22±0.30) mm and (1.40±0.26) cm, respectively. There were significant differences of the above parameters between groups (t=-2.242, 2.482, P=0.029, 0.016). Conclusion NVC manifestations in TN patients included increased REZ distance and decreased height difference between bilateral REZ and the origin of SCA. |
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