【摘要】：目的探討內(nèi)聽道3D-磁共振成像(MRI)薄層掃描后顱窩內(nèi)相關(guān)解剖學(xué)指標與原發(fā)性三叉神經(jīng)痛(PTN)發(fā)病及行微血管減壓術(shù)(MVD)治療預(yù)后的關(guān)系。方法選擇2013年3月—2015年3月新疆醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)外科收治的符合納入與排除標準的PTN患者63例為病例組,同時匹配性別、年齡、民族收集同時期本院體檢中心自愿接受MRI檢查的體檢健康者20例為對照組,術(shù)前均行顱腦MRI平掃及內(nèi)聽道3D-MRI薄層掃描,觀察后顱窩內(nèi)橋小腦角(CPA)容積、三叉神經(jīng)根體積、三叉神經(jīng)根橫截面積、三叉神經(jīng)根長度等相關(guān)解剖學(xué)指標,PTN患者均行MVD治療,根據(jù)預(yù)后分為有效組50例和無效組13例,分析一般資料及后顱窩內(nèi)相關(guān)解剖學(xué)指標與MVD治療預(yù)后的關(guān)系。結(jié)果對照組受試者左側(cè)與右側(cè)CPA容積、三叉神經(jīng)根體積、三叉神經(jīng)根橫截面積、三叉神經(jīng)根長度比較,差異均無統(tǒng)計學(xué)意義(P0.05)。PTN患者患側(cè)CPA容積、三叉神經(jīng)根體積、三叉神經(jīng)根橫截面積小于健側(cè)(P0.05);健側(cè)與患側(cè)三叉神經(jīng)根長度比較,差異無統(tǒng)計學(xué)意義(P0.05)。有效組與無效組PTN患者性別、年齡、民族、病變側(cè)別、累及三叉神經(jīng)分支、三叉神經(jīng)根長度比較,差異均無統(tǒng)計學(xué)意義(P0.05);有效組與無效組PTN患者病程、責(zé)任血管、血管與神經(jīng)關(guān)系、CPA容積、三叉神經(jīng)根體積、三叉神經(jīng)根橫截面積比較,差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論 CPA容積減小、三叉神經(jīng)根萎縮并體積及橫截面積變小是PTN產(chǎn)生的原因。病程長、責(zé)任血管為靜脈、血管與神經(jīng)有明確壓迫關(guān)系、CPA容積小、三叉神經(jīng)根萎縮并體積及橫截面積小的PTN患者行MVD治療后預(yù)后較其他患者差。
[Abstract]:Objective to investigate the relationship between anatomical indexes in fossa after 3D-magnetic resonance imaging (MRI) of internal auditory canal and prognosis of primary trigeminal neuralgia (PTN) and microvascular decompression (MVD). Methods 63 PTN patients admitted to the first affiliated Hospital of Xinjiang Medical University from March 2013 to March 2015 were selected as the case group, matching sex and age. Twenty healthy persons who volunteered to be examined by MRI in the physical examination center of our hospital at the same time were collected as the control group. The (CPA) volume of cerebellopontine angle in the posterior fossa was observed by plain scan of MRI and thin slice scan of internal auditory canal before operation. The patients with PTN were treated with MVD according to the volume of trigeminal nerve root, the cross section area of trigeminal nerve root and the length of trigeminal nerve root. According to the prognosis, they were divided into effective group (n = 50) and ineffective group (n = 13). The relationship between general data and anatomical indexes in posterior fossa and prognosis of MVD was analyzed. Results there were no significant differences in left and right CPA volume, trigeminal root cross section area and trigeminal nerve root length between the two groups (P 0.05). CPA volume and trigeminal root volume in patients with PTN, The cross section area of trigeminal nerve root was smaller than that of healthy side (P 0.05). There was no significant difference in the length of trigeminal nerve root between the healthy side and the affected side (P 0.05). There was no significant difference in sex, age, nationality, lesion side, involving trigeminal nerve branches and trigeminal nerve root length between the effective group and the ineffective group (P 0.05). There were significant differences in the course of disease, responsible blood vessels, relationship between blood vessels and nerves, CPA volume, trigeminal nerve root volume and cross section area of trigeminal nerve root between effective group and ineffective group (P 0.05). Conclusion the decrease of CPA volume, the atrophy of trigeminal nerve root and the decrease of cross section area are the causes of PTN. The prognosis of PTN patients with long course of disease, the responsible vessels were veins, and there was a clear compression relationship between blood vessels and nerves. The prognosis of PTN patients with small CPA volume, trigeminal nerve root atrophy and small volume and cross section area was worse than that of other patients after MVD treatment.
【作者單位】： 新疆醫(yī)科大學(xué)第一附屬醫(yī)院神經(jīng)外科;
【基金】：新疆維吾爾自治區(qū)自然科學(xué)基金資助項目(2014211C053)
【分類號】：R445.2;R745.11

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