摘要
目的前瞻性分析总结磁共振断层血管成像(magneticresonancetomographicangiography,MRTA)技术对面肌痉挛微血管减压(microvasculardecompression,MVD)手术疗效评价的作用。方法2001年1月至2003年12月对术前MRTA影像上存在明显血管压迫,且经济条件允许的83例面肌痉挛患者术后进行MRTA复查,并且进行1～4年的随访。同时对这一组患者手术前后MRTA影像进行对比研究。结果83例患者术后MRTA均反映出MVD手术中的改变,见到责任血管的移位,面神经减压充分。68例患者(81.9%)术后面部抽搐立即消失,并且在随访过程未出现任何手术侧面部抽动。15例患者(18.1%)症状消失延迟至术后1周～6个月,其中5例患者表现为术后2～3d面部抽动消失(静止期silentperiod)、抽动复现、抽动完全消失三个不同阶段。患者术后面肌痉挛(postoperativehemifacialspasm)的发生与责任血管类型无相关性(P>0.05)。结论MRTA为判断MVD手术疗效评价提供了可靠的依据。若术后MRTA影像显示减压满意,即使发生术后面肌痉挛也往往是一过性的,在恢复过程中能够自愈,不需要再次手术探查。MRTA为术后疗效预测提供了指导依据。
Objective This study was performed to investigate the value of postoperative magnetic resonance tomographic angiographic imaging in the prediction of clinical outcomes after microvascular decompression （MVD） for the treatment of hemifacial spasm. Methods We examined the preand postoperative MRTA images obtained between January 2001 and December 2003 for 83 patients wit hemifacial spasm, to evaluate the changes in the positions ofh offending vessels and the detachment of the vascular contact. These findings were compared with the surgical findings and clinical outcomes.Results All of 83 patients with MVD,completed decompression of offending vessels at the root entry zone of the facial never were observed, like the surgical findings, by using the postoperative MRTA. After MVD, 68 patients （81.9%） were spasm - free and 15 patients （18.1%） experienced residual spasm. Of the 15 residual spasm patients,5 patients exhibited an immediate postoperative silent period of 2-3 days without spasm. Furthermore, there was no significant relationship between the type of offending vessel and postoperative spasm（P〉0.05）. Conclusion Postoperative MRTA imaging is useful in decision the degree of the vascular decompression, and provide the information to predict the clinical outcomes.
出处
《立体定向和功能性神经外科杂志》
2005年第4期230-233,共4页
Chinese Journal of Stereotactic and Functional Neurosurgery
