【摘要】：研究目的：采用3.0T MR3D-TOF及3D-FIESTA序列檢測(cè)面神經(jīng)及周圍血管關(guān)系,探討責(zé)任血管構(gòu)成,責(zé)任血管與面神經(jīng)關(guān)系及易誘發(fā)面肌痙攣的血管類型。 方法：回顧分析163例偏側(cè)面肌痙攣及107例非偏側(cè)面肌痙攣3D-TOF及3D-FIESTA序列磁共振圖像。偏側(cè)面肌痙攣患者患側(cè)為病例組,健側(cè)及非偏側(cè)面肌痙攣患者雙側(cè)為對(duì)照組,主要觀察面神經(jīng)根部,分析面神經(jīng)與周圍責(zé)任血管關(guān)系,責(zé)任血管組成,易發(fā)病血管類型。將面神經(jīng)與責(zé)任血管之間關(guān)系分為5型。1型無(wú)血管,2型遠(yuǎn)離,3型接近,4型接觸,5型壓迫,其中4型,5型判為陽(yáng)性,1型,2型,3型判為陰性。 結(jié)果：163例偏側(cè)面肌痙攣患者及107例非偏側(cè)面肌痙攣患者共540側(cè),均清楚顯示面神經(jīng)根部及鄰近結(jié)構(gòu),其中病例組166側(cè)(3例為雙側(cè)發(fā)病),壓迫29側(cè),占病例組17.5%,接觸97側(cè),占病例組58.4%,對(duì)照組中偏側(cè)面肌痙攣健側(cè)組160側(cè),壓迫0例,接觸33例,占偏側(cè)面肌痙攣健側(cè)組的20.6%,非面肌痙攣組壓迫0例,接觸41例,占非面肌痙攣組的19.1%,經(jīng)統(tǒng)計(jì)學(xué)分析,對(duì)照組偏側(cè)面肌痙攣健側(cè)組與非面肌痙攣組雙側(cè)血管構(gòu)成無(wú)顯著差異,病例組與對(duì)照組(包括偏側(cè)面肌痙攣患者健側(cè)及非偏側(cè)面肌痙攣患者兩側(cè))差異有顯著意義(P0.05)。所有責(zé)任血管構(gòu)成比例,AICA占38.9%,PICA占35.7%,單獨(dú)VA占19.0%。椎動(dòng)脈聯(lián)合其他血管占4%。對(duì)所有病例組及對(duì)照組,椎動(dòng)脈接觸或壓迫與PICA、AICA接觸或壓迫進(jìn)行對(duì)比分析,發(fā)現(xiàn)27側(cè)椎動(dòng)脈接觸或壓迫中,24例發(fā)病,發(fā)病率：88.9%；71例PICA接觸或壓迫中45例發(fā)病,發(fā)病率63.4%；94例AICA接觸或壓迫中49例發(fā)病,發(fā)病率52.1%。 結(jié)論：磁共振3D-TOF及3D-FIESTA序列能清晰顯示面神經(jīng)及毗鄰結(jié)構(gòu)關(guān)系,特別是血管與面神經(jīng)關(guān)系；偏側(cè)面肌痙攣責(zé)任血管主要有AICA, PICA, VA;血管壓迫是偏側(cè)面肌痙攣的重要病因；椎動(dòng)脈壓迫較PICA、AICA壓迫更易發(fā)病。
[Abstract]:Objective: to investigate the relationship between facial nerve and peripheral blood vessels by using 3.0T MR3D-TOF and 3D-FIESTA sequences, and to explore the relationship between responsible blood vessels and facial nerves and the types of vessels that are prone to induce hemifacial spasm. Methods: 3D-TOF and 3D-FIESTA images of 163 cases of hemifacial spasm and 107 cases of non-hemifacial spasm were retrospectively analyzed. Patients with hemifacial spasm were treated with hemifacial spasm and those with contralateral and non-hemifacial spasm were treated as control group. The root of facial nerve was observed and the relationship between facial nerve and peripheral responsible blood vessels was analyzed. The relationship between the facial nerve and the responsible vessels was divided into type 5, type 1, no vessel, type 2, far away from type 3, close to type 4, contact type 5, type 4, type 1, type 2, type 3, type 3 were negative. Results 540 sides of 540 hemifacial spasm patients and 107 non-hemifacial spasm patients were found. The facial nerve roots and adjacent structures were clearly displayed in the case group. Among them, 166 sides in the case group (3 cases were bilateral disease), 29 sides were compressed, 17.5% of them were in the case group, 97 sides were in contact with each other. In the control group, there were 160 sides of hemifacial spasm, 0 cases of compression, 33 cases of contact, 20.6% of the contralateral group of hemifacial spasm, 0 cases of compression of non-hemifacial spasm group, 41 cases of contact with non-hemifacial spasm group, and 19.1% of non-hemifacial spasm group. There was no significant difference in bilateral vascular composition between hemifacial spasm group and non-hemifacial spasm group in control group, but there was significant difference between case group and control group (including both sides of hemifacial spasm group and non-hemifacial spasm group) (P0.05). The proportion of all responsible blood vessels was 38.9%, PICA was 35.7cm, VA was 19.0%. Vertebral artery combined with other blood vessels accounted for 4%. In all cases and control group, the vertebral artery contact or compression was compared with that of PICA AICA. It was found that 24 cases of vertebral artery contact or compression occurred in 27 sides, and 45 cases of 71 cases of PICA contact or compression with the incidence rate of 88.9% (63.4%). 49 out of 94 cases of AICA contact or compression, the incidence rate was 52.1%. Conclusion: MRI 3D-TOF and 3D-FIESTA sequences can clearly display the relationship between facial nerve and adjacent structures, especially the relationship between blood vessels and facial nerves, the main responsible vessels for hemifacial spasm are AICA, PICA, VA; vascular compression, which is an important cause of hemifacial spasm. Vertebral artery compression is more likely than PICA AICA compression.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R745.12

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