摘要
目的:研究三维稳态进动快速成像(3D-FIESTA)对原发性三叉神经痛(PTN)中的诊断价值。方法:选取医院收治的86例原发性PTN患者的临床资料,均于术前行3D-FIESTA序列检查,且均接受微血管减压术,术中明确患者受累神经及其责任血管,以术中检查结果为金标准,评估3D-FIESTA检查对原发性PTN责任血管分类诊断价值,分析3D-FIESTA检出血管神经接触率。结果:86例原发性PTN患者共检出责任血管83例,未见责任血管3例,且责任血管多为小脑上动脉、小脑后下动脉及小脑前下动脉,而3D-FIESTA检查对原发性PTN责任血管分类诊断的总体检出率与术中检查检出率比较差异无统计学意义;以术中诊断结果为金标准,3D-FIESTA检查诊断原发性PTN责任血管分类的灵敏度为92.77%、特异度为66.67%,准确率为91.86%,3D-FIESTA检查显示症状侧原发性PTN患者血管神经接触率明显高于无症状侧,差异有统计学意义(x2=6.913,P<0.05)。结论:3D-FIESTA对原发性PTN患者的责任血管分类以及血管神经接触的诊断价值较高,或可为原发性PTN合理治疗方案制定提供参考。
Objective:To explore diagnostic value of three-dimensional fast imaging employing steady state acquisition(3D-FIESTA)in primary trigeminal neuralgia(PTN).Methods:The clinical data of 86 PTN patients who admitted to hospital were collected.All of them underwent 3D-FIESTA sequence examination before microvascular decompression surgery.The involved nerves and their offending vessels were determined during surgery.The intraoperative examination results were used as golden standard to assess the diagnostic value of 3D-FIESTA examination in the classifications of offending vessels of PTN,and to analyze the detection rates of 3D-FIESTA examination for nervevascular contact in PTN patients.Results:Among 86 patients with PTN,83 cases with offending vessels were detected and the offending vessels didn’t be found in 3 cases.And the offending vessels mainly included superior cerebellar artery,posterior inferior cerebellar artery and anterior inferior cerebellar artery.However,the difference of the total detection rate of the classification diagnosis of offending vessels of PTN between 3D-FIESTA examination and intraoperative was no significant.The intraoperative diagnosis result was used as golden standard,and the sensitivity,specificity and accuracy of the diagnosis of 3D-FIESTA examination for the classifications of offending vessels of PTN were 92.77%,66.67%and 91.86%,respectively.3D-FIESTA examination showed vascular-nerve contact rate in patients with PTN at symptomatic side was significantly higher than that at asymptomatic side(x2=6.913,P<0.05).Conclusion:The diagnostic value of 3D-FIESTA is higher for the classification of offending vessels and vascular-nerve contact in patients with PTN,or it may provide reference for formulating rational therapeutic regimen of PTN.
作者
葛晗明
张格娟
薛永杰
常明则
GE Han-ming;ZHANG Ge-juan;XUE Yong-jie(Departments of Neurology,The Affiliated Hospitalof of Northwest University,Xi’an No.3 Hospital,Xi'an 710018,China)
出处
《中国医学装备》
2020年第12期68-71,共4页
China Medical Equipment
基金
陕西省重点研发计划(2018SF-035)“颅内动脉粥样硬化/支架后再狭窄与内皮祖细胞相关性SIRT3增强EPCs活性机制的研究”
西安市科技计划项目“科技”行动计划——医学研究项目[201805099YX7SF33(1)]“精神及心理疾病研究-基于定量脑电监测技术在血管性认知损害中频分析研究”。
