摘要
目的对比微血管减压手术前后磁共振血管成像变化情况,探讨其与手术疗效间的关系。方法对比12名患者手术前后磁共振血管成像图像,其中三叉神经痛8名,面肌抽搐3名,舌咽神经痛1名。观察血管与颅神经近脑干端的关系,判明责任血管,并与手术所见、术后症状改善情况进行对比。结果术前磁共振血管成像显示全部患者症状侧存在血管压迫。术中发现1例三叉神经痛患者责任血管除为小脑上动脉外,还存在岩静脉压迫,其余患者术中所发现均与术前磁共振血管成像吻合。其中,三叉神经痛患者责任血管为小脑上动脉5例,小脑前下动脉3例,面肌痉挛患者2例为小脑前下动脉,1例为小脑后下动脉;舌咽神经痛患者为异位椎动脉推挤小脑后下动脉压迫舌咽神经。术后全部病人症状消失,磁共振血管成像显示11名患者责任血管从颅神经表面分离开。结论磁共振血管成像能准确显示手术前后颅神经与毗邻动脉血管之间的关系,并为手术及术后疗效预测提供了影像学依据。
Objective To investigate the changes of pre-and postoperative magnetic resonance angiography in patients underwent microvascular decompression,and to explore its clinical value.Methods The pre-and postoperative 3D-TOF-MRA in 12 cases were examined in 12 patients（8 with trigeminal neuralgia,3 with hemifacial spasm,and 1 with glossopharyngeal neuralgia） between February 2009 and December 2009 for,and the changes in the positions of offending vessels and the detachment of the vascular contact were evaluated.These findings were compared with the surgical findings and clinical outcomes.Results All cases had vascular compression or contact at preoperative 3D-TOF MRA.Operative findings showed that the offending vessel was petrosal vein as well as superior cerebellar artery in cases of trigeminal neuralgia.The offending vessels of the trigeminal neuralgia patients were superior cerebellar artery in 5 cases and anterior inferior cerebellar artery in 3.And which of the hemifacial spasm was anterior inferior cerebellar artery in 2 cases,and posterior inferior cerebellar artery in 1.The glossopharyngeal neuralgia patient was distorted vertebral artery impact the posterior inferior cerebellar artery to compress the rootlet of the glossopharyngeal nerve.All of these patients exhibited excellent improvement after the MVD.11 of all patients completed decompression of offending vessels at the root entry zone of the cranial never were observed at postoperative 3D-TOF-MRA.Conclusion 3D-TOF-MRA can demonstrate the relationship of the cranial nerve with its surrounding vasculature.Postoperative 3D-TOF-MRA is useful in providing the information to predict the clinical outcomes.
出处
《宁夏医科大学学报》
2011年第10期931-933,949,F0004,共5页
Journal of Ningxia Medical University
关键词
磁共振血管成像
神经血管压迫
微血管减压
magnetic resonance angiography
neurovascular compression
microvascular decompression
