【摘要】：目的： 采用3.0TMR3D-TOF及3D-FIESTA序列檢測三叉神經(jīng)及周圍血管關(guān)系,探討責(zé)任血管構(gòu)成,責(zé)任血管與三叉神經(jīng)關(guān)系及易誘發(fā)三叉神經(jīng)痛的血管類型。 方法： 回顧分析105例三叉神經(jīng)痛患者及80例非三叉神經(jīng)痛患者3D-TOF及3D-FIESTA序列磁共振圖像。取三叉神經(jīng)痛患者患側(cè)為病例組,健側(cè)及非三叉神經(jīng)痛患者雙側(cè)為對(duì)照組,主要針對(duì)三叉神經(jīng)根部,觀察三叉神經(jīng)與周圍血管關(guān)系,責(zé)任血管組成,易發(fā)病血管類型。將三叉神經(jīng)與周圍血管之間關(guān)系分為5型。1型無血管,2型遠(yuǎn)離,3型接近,4型接觸,5型壓迫,其中4型、5型判為陽性,1型、2型、3型判為陰性。 結(jié)果： 105例三叉神經(jīng)痛患者及80例非三叉神經(jīng)痛患者共370側(cè),其中病例組106側(cè)(1例為雙側(cè)發(fā)病),壓迫27側(cè),占病例組25.5%,接觸53側(cè),占病例組50.0%,對(duì)照組中三叉神經(jīng)痛健側(cè)組104側(cè),壓迫0例,接觸16例,占三叉神經(jīng)痛健側(cè)組的15.4%,非三叉神經(jīng)痛組160側(cè),壓迫0例,接觸26例,占非三叉神經(jīng)痛組的16.3%。經(jīng)統(tǒng)計(jì)學(xué)分析,對(duì)照組中三叉神經(jīng)痛健側(cè)組與非三叉神經(jīng)痛組雙側(cè)血管構(gòu)成無顯著差異,病例組與對(duì)照組(包括三叉神經(jīng)痛患者健側(cè)及非三叉神經(jīng)痛患者兩側(cè))差異有顯著意義(P0.05)。所有責(zé)任血管構(gòu)成比例,小腦上動(dòng)脈(SCA)占71.25%,小腦前下動(dòng)脈(AICA)占20.0%,基底動(dòng)脈(BA)占2.5%,兩支血管聯(lián)合占5.0%,靜脈占1.25%。 結(jié)論： 磁共振3D-TOF聯(lián)合3D-FIESTA序列能清晰顯示三叉神經(jīng)及毗鄰結(jié)構(gòu)關(guān)系,特別是血管與三叉神經(jīng)關(guān)系；三叉神經(jīng)痛責(zé)任血管主要有SCA,AICA,BA;血管壓迫是三叉神經(jīng)痛的重要病因。
[Abstract]:Objective: to detect the relationship between trigeminal nerve and peripheral blood vessels by 3.0TMR3D-TOF and 3D-FIESTA sequences, and to explore the composition of responsible vessels, the relationship between responsible vessels and trigeminal nerves, and the types of blood vessels that are easy to induce trigeminal neuralgia. Methods: the 3D-TOF and 3D-FIESTA sequence magnetic resonance images of 105 patients with trigeminal neuralgia and 80 patients with non-trigeminal neuralgia were analyzed retrospectively. The affected side of trigeminal Neuralgia was taken as the case group, and the healthy side and bilateral side of non-trigeminal Neuralgia as control group. The relationship between trigeminal nerve and peripheral blood vessels, the composition of responsible blood vessels and the types of blood vessels were observed. The relationship between trigeminal nerve and peripheral blood vessels was divided into 5 types. Type 1 was non-vascular, type 2 was far away, type 3 was close, type 4 contact, type 5 compression, of which type 4, type 5 were positive, type 1, type 2 and type 3 were negative. Results: there were 370 sides of 105 patients with trigeminal neuralgia and 80 patients with non-trigeminal neuralgia, including 106 sides of case group (1 case of bilateral onset), 27 sides of compression (25.5%), 53 sides of contact (50.0%), 104 sides of healthy side of trigeminal neuralgia group, 0 cases of compression, 16 cases of contact, accounting for 15.4% of the healthy group of trigeminal neuralgia, 160 sides of non-trigeminal neuralgia group and 0 cases of compression. 26 cases were exposed, accounting for 16.3% of the non-trigeminal neuralgia group. Statistical analysis showed that there was no significant difference in bilateral vascular composition between the healthy side group and the non-trigeminal neuralgia group, but there was significant difference between the case group and the control group (including the healthy side and the two sides of the non-trigeminal neuralgia group) (P 0.05). The proportion of all responsible vessels was 72.5% in superior cerebellar artery, 20.0% in anterior inferior cerebellar artery, 2.5% in basilar artery, 5.0% in combination of two vessels and 1.25% in vein. Conclusion: magnetic resonance 3D-TOF combined with 3D-FIESTA sequence can clearly show the relationship between trigeminal nerve and its adjacent structure, especially the relationship between blood vessel and trigeminal nerve, and SCA,AICA,BA; vascular compression is an important cause of trigeminal neuralgia.
【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)】：R745.11

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