3D-TOF-MRA与3D-FIESTA融合三维影像在原发性三叉神经痛侵犯血管判断中的价值

Q4 Medicine

中华神经外科杂志 Pub Date : 2019-09-28 DOI:10.3760/CMA.J.ISSN.1001-2346.2019.09.013

Yingbin Jiao, F. Duan, Zhiyong Yan, Qing-hai Meng, Yugong Feng

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引用次数: 2

摘要

目的探讨三维时间飞行磁共振血管造影(3D-TOF-MRA)和三维快速成像(3D-FIESTA)融合三维图像在原发性三叉神经痛(PTN)责任血管识别中的价值。方法回顾性分析2016年1月至2019年6月青岛大学附属医院神经外科行微血管减压术(MVD)治疗的48例PTN患者。所有患者术前均行3D-TOF-MRA和3D-FIESTA序列检查。利用3d切片软件将3D-TOF-MRA和3D-FIESTA序列图像融合，进行三维重建。以MVD为标准，评估3D-TOF-MRA, 3D-FIESTA和融合图像，以确定责任血管及其对神经的压迫程度。结果MVD除1例无犯血管外，其余47例犯血管清晰。有40例患者仅为动脉血管，2例为静脉血管，5例动脉和静脉都有。3D-TOF-MRA结果显示，5例患者无犯血管，43例患者有动脉为犯血管。3D-FIESTA显示4例无病变血管;病变血管为动脉36例，静脉3例，动静脉兼有5例。融合图像显示2例无病变血管;病变血管为动脉39例，静脉2例，动静脉兼有5例。以MVD为标准，3D- tof - mra、3D- fiest和融合3D图像判断病变血管存在与否的准确率分别为91.7%(44/48)、93.8%(45/48)和97.9%(45/48)。3D-TOF-MRA、3D-FIEST及融合影像对病变血管的正确识别准确率分别为54.2%(26/48)、89.6%(43/48)和93.8%(45/48)。与术中表现相比，3种影像均显示神经受压程度较轻，差异均有统计学意义(P<0.05)。结论与3D-TOF-MRA和3D-FIESTA单序列相比，融合后的图像对PTN病变血管的识别似乎更准确，但仍存在对神经压迫程度的低估。关键词:三叉神经痛;冒犯船;三维飞行时间磁共振血管造影;采用稳态采集的三维快速成像;Microva-scular减压

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The value of 3D-TOF-MRA and 3D-FIESTA fusion three-dimensional images in judgment of offending vessel in primary trigeminal neuralgia

Objective To investigate the value of three-dimensional time-flying magnetic resonance angiography (3D-TOF-MRA) and three-dimensional fast imaging employing steady-state acquisition sequence (3D-FIESTA) fusion three-dimensional image in identification of offending vessels of primary trigeminal neuralgia (PTN). Methods A total of 48 patients with PTN who underwent microvascular decompression (MVD) from January 2016 to June 2019 at Department of Neurosurgery, Affiliated Hospital of Qingdao University were retrospectively enrolled into this study. All patients underwent 3D-TOF-MRA and 3D-FIESTA sequence examinations before operation. The 3D-slicer software was used to fuse 3D-TOF-MRA and 3D-FIESTA sequence images and conduct three-dimensional reconstruction. Using MVD as a standard, 3D-TOF-MRA, 3D-FIESTA and fused images were evaluated to determine the offending vessels and their compressive degree on the nerves. Results In MVD, except for 1 patient who had no offending vessel, the other 47 patients had clear offending vessels. The offending vessels were merely arteries in 40 cases, veins in 2, and both arteries and veins in 5. The 3D-TOF-MRA results showed that 5 patients had no offending vessels, and the remaining 43 patients had arteries as offending vessels. The 3D-FIESTA showed that 4 cases had no offending vessels; the offending vessels were arteries in 36 cases, veins in 3 cases, and both arteries and veins in 5 cases. The fused images showed that there were 2 cases without offending vessels; the offending vessels were arteries in 39 cases, veins in 2 cases, and both arteries and veins in 5 cases. Using the MVD as the standard, the accuracy of 3D-TOF-MRA, 3D-FIEST and fusion 3D images for determining the presence/absence offending vessels was 91.7% (44/48), 93.8% (45/48) and 97.9%(45/48), respectively. The accuracy of correct identification of offending vessels by 3D-TOF-MRA, 3D-FIEST and fused images was 54.2% (26/48), 89.6% (43/48) and 93.8% (45/48), respectively. Compared with intraoperative findings, those 3 types of images commonly showed lighter degree of nerve compression, and the differences were statistically significant (all P<0.05). Conclusion Compared with 3D-TOF-MRA and 3D-FIESTA single sequences, the fused images seem to be more accurate in identification of the offending vessels of PTN, which, however, is still associated with underestimation of the nerve compression degree. Key words: Trigeminal neuralgia; Offending vessel; Three-dimensional time-of-flight magnetic resonance angiography; Three-dimensional fast imaging employing steady-state acquisition; Microva-scular decompression

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来源期刊

中华神经外科杂志 Medicine-Surgery

CiteScore

0.10

自引率

0.00%

发文量

10706

期刊介绍： Chinese Journal of Neurosurgery is one of the series of journals organized by the Chinese Medical Association under the supervision of the China Association for Science and Technology. The journal is aimed at neurosurgeons and related researchers, and reports on the leading scientific research results and clinical experience in the field of neurosurgery, as well as the basic theoretical research closely related to neurosurgery.Chinese Journal of Neurosurgery has been included in many famous domestic search organizations, such as China Knowledge Resources Database, China Biomedical Journal Citation Database, Chinese Biomedical Journal Literature Database, China Science Citation Database, China Biomedical Literature Database, China Science and Technology Paper Citation Statistical Analysis Database, and China Science and Technology Journal Full Text Database, Wanfang Data Database of Medical Journals, etc.