本文關(guān)鍵詞：面聽神經(jīng)腦池-內(nèi)耳道段及與鄰近血管關(guān)系的磁共振研究　出處：《河北醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 核磁共振 面神經(jīng) 聽神經(jīng) 3D-FIESTA序列 3D-TOP序列 原發(fā)性面肌痙攣 感音神經(jīng)性耳聾 責(zé)任血管

【摘要】：目的:MRI因具有很高的組織分辨力,可以清晰顯示出腦池-內(nèi)耳道段的面聽神經(jīng)及其鄰近血管的走行,對(duì)面聽神經(jīng)與周圍血管關(guān)系的診斷具有理想的作用。本課題運(yùn)用3.0MR對(duì)正常人面聽神經(jīng)腦池-內(nèi)耳道段及周圍解剖關(guān)系進(jìn)行研究,包括測(cè)量面聽神經(jīng)本身的結(jié)構(gòu)數(shù)據(jù)及功能成像,并對(duì)面聽神經(jīng)與周圍血管解剖關(guān)系進(jìn)行詳細(xì)分類,進(jìn)而對(duì)面聽神經(jīng)相關(guān)疾病的臨床診斷奠定基礎(chǔ)。方法:1收納健康志愿者105例,記錄志愿者基本信息如年齡、性別、臨床癥狀和體征,排除頭部手術(shù)及面聽神經(jīng)引起的面肌痙攣、神經(jīng)性耳聾等癥狀于我院行MR T2FLAIR、3D-TOF序列及3D-FIESTA序列檢查。并通過常規(guī)T2FLAIR圖像排除志愿者腦梗死、顱內(nèi)腫瘤、腦干、橋小腦角區(qū)占位性病變、巖骨畸形等疾病,3D-FIESTA序列圖像用于面聽神經(jīng)的重組與測(cè)量。3D-TOF序列用于區(qū)分面聽神經(jīng)周圍的動(dòng)靜脈。2利用3D-FIESTA序列對(duì)圖像進(jìn)行冠、矢狀面重建,仔細(xì)觀察神經(jīng)的走行、粗細(xì)、形態(tài)等情況,測(cè)量面聽神經(jīng)腦池-內(nèi)耳道段的長(zhǎng)度,并分別統(tǒng)計(jì)左右兩側(cè)面聽神經(jīng)長(zhǎng)度有無差異性。3將腦池-內(nèi)耳道段中內(nèi)耳道段內(nèi)有無血管袢以及血管袢探入的深度分為三種類型:Ⅰ型,內(nèi)耳道段不存在血管袢;Ⅱ型,在內(nèi)耳道段存在血管袢,但是血管袢進(jìn)入深度不足內(nèi)耳道深度50%;Ⅲ型,為內(nèi)耳道段存在血管袢,并且進(jìn)入深度超過內(nèi)耳道段深度的50%。4仔細(xì)觀察鄰近血管與神經(jīng)距離最近處的部位,測(cè)量血管與神經(jīng)的距離,根據(jù)測(cè)量的距離將血管與神經(jīng)的關(guān)系分為四種關(guān)系:1壓迫關(guān)系:神經(jīng)和血管的接觸部位有血管壓跡,血管對(duì)其受壓偏移;2接觸關(guān)系:神經(jīng)和鄰近的血管之間最短距離為0;3鄰近關(guān)系:神經(jīng)和鄰近的血管之間最短距離在0-1mm之間;4遠(yuǎn)離關(guān)系:神經(jīng)和鄰近的血管之間最短距離在1mm以上。5面聽神經(jīng)根與周圍血管的關(guān)系,在原始圖像及重組圖像上觀察鄰近血管與同側(cè)面聽神經(jīng)根長(zhǎng)軸的最短距離處相應(yīng)血管相對(duì)于神經(jīng)根的方位(分上、下、內(nèi)、外四個(gè)方位)。結(jié)果:1左右兩側(cè)面神經(jīng)長(zhǎng)度分別為2.0160±0.11647cm、2.0197±0.12807cm,左右聽神經(jīng)長(zhǎng)度分別為1.9815±0.18884cm、1.9762±0.19072cm。面、聽神經(jīng)長(zhǎng)度分別在左右側(cè)之間無統(tǒng)計(jì)學(xué)差異(P=0.643、P=0.087)。2面聽神經(jīng)腦池-內(nèi)耳道段血管袢與神經(jīng)關(guān)系分型中Ⅰ型最多,左右兩側(cè)分別占61.9%、56.2%,其次為Ⅱ型較多,左右兩側(cè)分別占25.7%、30.5%,Ⅲ型最少,左右兩側(cè)分別占12.4%、13.3%;各型所占比例分別在左右兩側(cè)之間無統(tǒng)計(jì)學(xué)差異(P=0.687)。3雙側(cè)面聽神經(jīng)血管袢與神經(jīng)關(guān)系分型中,在Ⅰ型中遠(yuǎn)離關(guān)系所占比例最大,右側(cè)面神經(jīng)、聽神經(jīng)分別占49.2%、54.2%,左側(cè)面神經(jīng)、聽神經(jīng)分別占43.1%、47.7%;Ⅲ型中接觸關(guān)系所占比例最大,右側(cè)面神經(jīng)、聽神經(jīng)分別占64.3%、57.2%,左側(cè)面神經(jīng)、聽神經(jīng)分別占61.5%、53.8%;Ⅱ型介于Ⅰ型和Ⅲ型之間,在所有志愿者中,未發(fā)現(xiàn)血管與神經(jīng)之間存在壓迫關(guān)系的病例。4鄰近血管與同側(cè)面聽神經(jīng)根長(zhǎng)軸的最短距離處相應(yīng)血管相對(duì)于神經(jīng)根的方位中,上方所占比例最多,占41.4%,其次為內(nèi)側(cè)和外側(cè)較多,所占比例分別為32.9%、19.0%,下方所占比例最小,占6.7%。結(jié)論:1面、聽神經(jīng)長(zhǎng)度分別在左右側(cè)之間無統(tǒng)計(jì)學(xué)差異。2面聽神經(jīng)腦池-內(nèi)耳道段血管袢與神經(jīng)關(guān)系分型中Ⅰ型最多,Ⅲ型最少,各型所占比例分別在左右兩側(cè)之間無統(tǒng)計(jì)學(xué)差異。3血管與神經(jīng)伴行距離越長(zhǎng),發(fā)生接觸關(guān)系的幾率越大。4鄰近血管與同側(cè)面聽神經(jīng)根長(zhǎng)軸的最短距離處相應(yīng)血管相對(duì)于神經(jīng)根的方位中上、內(nèi)方最多,下方最少。
[Abstract]:Objective: MRI has very high resolution, can clearly show the brain pool - inner ear segment of the facial nerve and adjacent vessels for action audiory diagnosis related nerve and the surrounding vessels has ideal. The subject of the use of the ear canal and around 3.0MR of normal human facial nerve cisternal in anatomy study, including the measurement of the surface to data structure and function of nerve itself and imaging, and audiory nerve and peripheral vascular anatomy relationship breakdown, and audiory nerve related diseases clinical diagnosis basis. Methods: 1 healthy volunteers received 105 cases, volunteers record basic information such as age, gender, the clinical symptoms and signs, and eliminate head surgery facial nerve caused by hemifacial spasm, nerve deafness and other symptoms in our hospital of MR T2FLAIR, 3D-TOF sequence and 3D-FIESTA sequence. And check by conventional T2FLAIR image In addition to volunteers, cerebral infarction, intracranial tumor, brain stem, cerebellopontine angle lesions, petrous bone deformity and other diseases, 3D-FIESTA image sequence for the facial nerve reconstruction and measurement of.3D-TOF sequence is used to distinguish the facial nerve around the arteriovenous.2 using 3D-FIESTA sequence of crown image, sagittal reconstruction, carefully observe the nerve walk the line, thickness, morphology, measurement of facial nerve cisternal - inner ear length, and statistics were on both sides of the facial nerve length difference of.3 - cisternal canal segment in the inner ear section has no blood vessels and vascular loops into the depth is divided into three types type I: canal segment, there is no vascular loop; type II, vascular loop in the inner ear, but lack of depth in the inner ear blood vessels into the depth of 50%; type III, as the canal segment vascular loops, and enter the depth over canal segment depth 50%.4 Zi Fine observation on adjacent blood vessels and nerves from the nearest part of the measurement of blood vessels and nerves in the distance, according to the measurement of the distance relationship between blood vessels and nerves are divided into four kinds of relationship: 1 compression relationship: contact part of the nerves and blood vessels with vascular compression, the compression of vascular migration; 2 Contact: relationship between the nerve and the the adjacent blood vessels and the shortest distance is 0; 3 adjacent relationship between the nerve and adjacent vessels: the shortest distance between 0-1mm; 4 from the relationship between the nerve and adjacent blood vessels: the shortest distance of over 1mm.5 to nerve roots and peripheral vascular and adjacent blood vessels with the same side to observe nerve root axis the shortest distance between the original image and the image corresponding to the recombinant vascular nerve root orientation (points, and in the four directions). Results: 1 of two facial nerve length were 2.0160 + 0.11647cm, 2.0197 + 0.12807cm, long around the auditory nerve Were 1.9815 + 0.18884cm, 1.9762 + 0.19072cm., the auditory nerve length on the left side were no significant difference between (P=0.643, P=0.087).2 of the facial nerve canal segment - cisternal vascular loops and neural relationship between type I type in the most left and right sides respectively 61.9%, 56.2%, followed by type II more. The left and right sides respectively 25.7%, 30.5%, type III at the left and right sides are respectively accounted for 12.4% and 13.3%; the proportion in the left and right sides were no significant difference between (P=0.687).3 double side of the auditory nerve and nerve vascular loop type relationship, away from the relationship in the type I in the largest proportion of the right facial nerve the auditory nerve, respectively 49.2%, 54.2%, left facial nerve and auditory nerve accounted for 43.1%, 47.7%; contact type III in the largest proportion of the right facial nerve, acoustic nerve accounted for 64.3%, 57.2%, left facial nerve and auditory nerve accounted for 61.5%, 53.8%; type II is 1 Between type I and type III, in all the volunteers, found no cases of vascular compression.4 adjacent relationship between vessels and nerves and nerve root of the long axis of the same side to the shortest distance relative to the corresponding vascular nerve root range, above the largest proportion, accounting for 41.4%, followed by the inside and outside more, accounted for the ratio was 32.9%, 19%, below the minimum proportion, accounting for 6.7%. conclusions: 1, the auditory nerve length on the left side were no significant difference between the.2 facial nerve canal segment - cisternal vascular loops and neural relationship between type I type III most, at least, the proportion in the both sides have no significant difference between.3 and vascular nerve accompanying the longer distance, the greater the probability of contact between.4 and adjacent blood vessels with facial acoustic nerve root long axis is the shortest distance relative to the corresponding vascular nerve root orientation, inside the most, The bottom is the least.

【學(xué)位授予單位】：河北醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R445.2

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