本文關(guān)鍵詞：運動眼球外肌的腦神經(jīng)腦池段的MRI重建觀測　出處：《新鄉(xiāng)醫(yī)學(xué)院》2014年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 腦神經(jīng)腦池段 眼球外肌 MRI 三維重建

【摘要】：背景斜視是國內(nèi)外的常見病,對患者的外觀形象、視覺功能及其學(xué)習(xí)、工作、心理均有較大的影響。神經(jīng)源性斜視是非共同性斜視中較復(fù)雜的特殊性斜視,包括運動眼球外肌的動眼神經(jīng)(Ⅲ)、滑車神經(jīng)(Ⅳ)和展神經(jīng)(Ⅵ)的麻痹性斜視等。磁共振成像(MRI)具有強大的多平面重組技術(shù)(MPR)等圖像后處理的重建技術(shù),在腦脊液背景的襯托下可以清晰顯現(xiàn)運動眼球外肌的腦神經(jīng)腦池段及其周圍結(jié)構(gòu),并能夠進行直觀、準確的空間定位。目的利用MRI圖像后處理的多平面重組技術(shù)(MPR),觀測運動眼球外肌的動眼神經(jīng)(Ⅲ)、滑車神經(jīng)(Ⅳ)和展神經(jīng)(Ⅵ)的腦池段,在MRI重建影像上的長度、夾角、傾斜度以及與鄰近血管的位置關(guān)系等,為臨床辨別神經(jīng)源性或肌源性的斜視提供診斷依據(jù)。材料和方法收集駐馬店市中心醫(yī)院影像科,2013年1月至2014年6月期間,施行頭部MRI三維快速平衡穩(wěn)態(tài)成像技術(shù)(3D-FIESTA)序列掃描的檢查者影像100例(200側(cè)),其中男、女性各50例,年齡20-66歲。將被檢查者的全部原始影像數(shù)據(jù)輸入三維重建工作站,利用多平面重組技術(shù)(MPR),分別在斜橫斷位、斜矢狀位、冠狀位上,以層厚0.50 mm進行影像重建。觀測動眼神經(jīng)(Ⅲ)、滑車神經(jīng)(Ⅳ)和展神經(jīng)(Ⅵ)腦池段的長度、夾角、傾斜度以及與鄰近血管的位置關(guān)系等。結(jié)果1.在斜橫斷位、斜矢狀位重建影像上,分別有97%(97/100)、97%(97/100)被檢查者能夠完整顯示雙側(cè)動眼神經(jīng)(Ⅲ)的腦池段；在冠狀位重建影像上,100%(100/100)被檢查者的雙側(cè)動眼神經(jīng)(Ⅲ)呈點狀。動眼神經(jīng)(Ⅲ)腦池段的長度、與正中矢狀面夾角、傾斜度分別為(17.44±2.16)mm、(24.43±±5.25)°、(69.444±8.79)。,與大腦后動脈的接觸率、分離率分別為56.0%(112/200)、44.0%(88/200),與小腦上動脈的接觸率、分離率分別為60.0%(120/200)、40.0%(80/200)。大腦后動脈走行于動眼神經(jīng)(Ⅲ)腦池段的上、下方分別為100.0%(100/200)、0.0%(0/200),小腦上動脈走行于動眼神經(jīng)(Ⅲ)腦池段的上、下方分別為1.0%(2/200)、99.0%(198/200)。大腦后動脈走行于動眼神經(jīng)(Ⅲ)腦池段的近側(cè)段、中間段、遠側(cè)段分別為40.5%(81/200)、56.0%(112/200)、3.5%(7/200),小腦上動脈走行于動眼神經(jīng)(Ⅲ)腦池段的近側(cè)段、中間段、遠側(cè)段分別為32.0%(64/200)、66.5%(133/200)、1.5%(3/200)。2.在斜橫斷位、斜矢狀位重建影像上,分別有93%(93/100)、82%(82/100)被檢查者能夠完整顯示雙側(cè)滑車神經(jīng)(Ⅳ)腦池段;在冠狀位重建影像上,79%(79/100)被檢查者的雙側(cè)動眼神經(jīng)(Ⅲ)呈點狀�；嚿窠�(jīng)(Ⅳ)腦池段的起點至小腦幕長度、至正中線距離分別為(7.70±1.84)mm、(5.63±1.11)mm,與小腦幕游離緣的位置關(guān)系即緊貼、隱蔽分別為58.5%(117/200)、41.5%(83/200)�；嚿窠�(jīng)(Ⅳ)腦池段有88側(cè)分支血管與73側(cè)滑車神經(jīng)(Ⅳ)有接觸點,與滑車神經(jīng)(Ⅳ)起點處之間的距離平均為3.4 mm；有66側(cè)分支血管與59側(cè)滑車神經(jīng)(Ⅳ)相鄰但并不相接觸,相鄰處與滑車神經(jīng)(Ⅳ)起點處之間的距離平均為3.1 mm。3.在斜橫斷位、斜矢狀位重建影像上,分別有97%(97/100)、99%(99/100)被檢查者能夠完整顯示雙側(cè)展神經(jīng)(Ⅵ)腦池段；在冠狀位重建影像上,75%(95/100)被檢查者能夠顯示呈條狀或點狀的展神經(jīng)(Ⅵ)腦池段。展神經(jīng)(Ⅵ)腦池段的長度、與正中矢狀面夾角、傾斜度分別為(15.604±2.81)mm、(32.46±7.73)°、(52.37±8.50)°,與小腦下前動脈的接觸率、分離率分別為75.5%(151/200)、24.5%(49/200)。小腦下前動脈走行于展神經(jīng)(Ⅵ)腦池段的上、下方分別為29.5%(59/200)、65.0%(130/200),其中有5.5%(11/200)不能區(qū)分其上、下方關(guān)系。結(jié)論1.MRI三維快速平衡穩(wěn)態(tài)成像技術(shù)序列(3D-FIESTA)結(jié)合多平面重組技術(shù)(MPR),可以清晰地顯示動眼神經(jīng)(Ⅲ)、滑車神經(jīng)(Ⅳ)、展神經(jīng)(Ⅵ)的腦池段及其毗鄰結(jié)構(gòu)的位置關(guān)系。2.動眼神經(jīng)(Ⅲ)、滑車神經(jīng)(Ⅳ)和展神經(jīng)(Ⅵ)的腦池段及其毗鄰結(jié)構(gòu)MRI重建影像的觀測,為腦神經(jīng)發(fā)育異常的診斷提供了直觀的形態(tài)學(xué)依據(jù),也為臨床辨別神經(jīng)源性或肌源性的斜視提供了診斷依據(jù)。
[Abstract]:The background of strabismus is a common disease of patients at home and abroad, the appearance of the image, visual function and learning, work, great psychological impact both. Neuropathic strabismus is a special complicated incomitant strabismus in strabismus, including the movement of extraocular muscles of the oculomotor nerve (III), (IV) the trochlear nerve and abducent nerve (VI) the paralytic strabismus. Magnetic resonance imaging (MRI) has a powerful multi planar reconstruction (MPR) image postprocessing reconstruction techniques, in contrast to the background can be clearly shown in cerebrospinal fluid of cerebral nerve and its surrounding structure movement of extraocular muscles, and can be intuitive, accurate positioning. By using the MRI image postprocessing of multiplanar reconstruction (MPR), to observe the motion of extraocular muscles of the oculomotor nerve (III), (IV) the trochlear nerve and abducent nerve (VI) in the cisternal segment, MRI reconstruction image length, angle, inclination, and o The relationship between the position of near blood vessels, provide the basis for clinical diagnosis to identify neurogenic or myogenic strabismus. Department of imaging materials and methods from the Central Hospital of Zhumadian, during the period from January 2013 to June 2014, the implementation of head MRI rapid 3D steady state imaging (3D-FIESTA) sequence scanning inspection images of 100 cases (200 sides), which male, female 50 cases, aged 20-66 years old. All the original image data will be checked the input 3D reconstruction workstation using multiplanar reconstruction (MPR), respectively, in the oblique transverse, oblique sagittal, coronal, with thickness of 0.50 mm for image reconstruction. The observation of oculomotor nerve (III). (IV) the trochlear nerve and abducent nerve (VI) cisternal segment length, angle, inclination and position relationship with adjacent vessels. Results in the 1. transverse oblique, oblique sagittal reconstruction images, respectively 97% (97/100), 97% (97/100) can be checked 澶熷畬鏁存樉紺哄弻渚у姩鐪肩緇，

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