三叉神经根入脑干区MRI形态学研究-论文.pdf

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1、临床神经外科杂志2014年第11卷第1期29doi：10．3969／j．issn．1672-7770．2014．01．009论著三叉神经根人脑干区MRI形态学研究周勇智，邹元杰，刘永，刘宏毅，刘文，肖朝勇【摘要】目的研究原发性三叉神经痛(TN)患者三叉神经根入脑干区(REZ)的形态结构及其临床应用价值。方法36例TN患者和20例非TN患者作为健康对照纳入研究。所有受试对象采用3．OTMRI扫描，采用可变翻转角的三维快速自旋回波序列(3D—SPACE)分别扫描两侧REZ区的形态学结构。采取图像分析软件测量分析三叉神经脑池段长度、三叉神经脑桥角、桥小脑角池面积和三叉神经脑池段面积。结果患侧

2、三叉神经脑池段长度的均值、三叉神经脑桥角的均值、桥小脑角池面积的均值以及三叉神经脑池段面积的均值均小于健侧。对照组的三叉神经脑池段长度、三叉神经脑桥角、桥小脑角池面积及三叉神经脑池段面积的均值均大于疾病组。结论三叉神经脑池段较短，三又神经脑桥角锐利，易发生神经血管冲突，临床上易导致TN；三叉神经脑池段面积缩小提示三叉神经根的萎缩性改变。MRI形态学信息有利于疾病的诊断及手术决策的选择。【关键词】三叉神经痛；磁共振成像；形态学结构；发病机制【中图分类号】R745．1【文献标识码】A【文章编号】1672-7770(2014)01-0029-04MRIstudyonmorphological

3、characteristicsoftrigeminalnerverootentryzoneZHOU一zhi，ZOUYuan-fie，LIU】，0，eta1．DepartmentofNeurosurgery，NanjiagBrainHospitalaffiliatedtoNanjingMedicalUniversity，Nanjing210029，ChinaAbstract：ObjectiveToevaluatethemorphologicalstructuresofthetrigeminalnerverootentryzone(REZ)inpatientswithtrigeminaln

4、euralgia(TN)andtheirclinicalvalues．Methods36patientswithTNand20healthycontrolswereenrolled．Allthesubjectswerescannedbyhigh—resolution3．0TMRI．3Dsamplingperfectionwithapplicationoptimizedcontrastsusingdifferentflipangleevolutions(3D—SPACE)wereusedtomeasurebilaterallymorphologicalstructuresofREZ．Re

5、sultsThemeanlengthofthecisternalsegmentofthetrigeminalnerve，thetrigeminal—pontineangle，thecross—sectionalareaofthecerebellopontineangle(CPA)cisternandthecross—sectionalareaofthecisternalsegmentofthetrigeminalnerveonthesymptomaticsideweresmallerthanthatontheasymptomaticside．Andalltheabovemorpholo

6、gicalparameterstendedtobelargerincontrolsthaninpatients．ConclusionsShoflercisternaltrigeminalnerveandsharpertrigeminal—pontineangleincreasethechanceofneurovascularconflict(NVC)，andaremorelikelytocauseTN．Thesmallerareaoftheeisternalsegmentoftrigeminalnerveisindicativeoftrigeminalnerveatrophyresul

7、tedfromlong—termcompression．TheseparameterscanbeusedfordiagnosticindicatorsofTNandsurgicaldecision．making．Keywords：~igen／nalneuralgia；mac~llanceimaging；morphologicalstructtwe；pathogenesis颅神经根周边异常或扭曲的血管压迫神经根，肯定，安全_1,3-4]。为了进一