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血管压迫性面肌痉挛的磁共振断层血管成像表现及其诊断价值 被引量:10

MRTA imaging of vascular compressive hemifacial spasm and its diagnostic value
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摘要 目的评价磁共振断层血管成像(magnetic resonance tomographic angiography,MRTA)显示面神经与周围血管三维空间关系的能力,探讨MRTA对血管压迫性面肌痉挛(hemifacial spasm,HFS)的诊断价值。方法回顾分析210例HFS患者临床及MR资料,并与手术结果进行对照。结果 210例HFS患者,MRTA显示患侧(共215侧,双侧症状5例)有血管压迫和接触面神经分别109侧和86侧,可疑接触9侧,阳性率为94.9%;健侧(205侧)面神经有血管压迫和接触分别12侧和23侧,可疑接触6侧,阳性率为20%。HFS患者患侧与健侧面神经与邻近血管解剖关系上,差异有统计学意义,其症状与血管接触或压迫面神经有显著相关性(P<0.01)。80例手术患者术中见78例有血管压迫或接触,未见责任血管2例;71例术前MRTA与术中所见完全相符,4例术前MRTA阴性患者,术中3例见静脉责任血管。以手术结果为金标准,MRTA诊断HFS的灵敏度为96.2%,诊断符合率95.0%。结论MRTA是术前诊断HFS病因无创、有效的检查方法,能清楚显示面神经与周围血管的空间关系,为HFS的诊治提供可靠的影像学依据。 Objective To evaluate the capability of magnetic resonance tomographic angiography( MRTA) to represent three-dimensional relationship between the facial nerves and the adjacent blood vessels,and to discuss the diagnostic value of MRTA in vascular compressive hemifacial spasm( HFS). Methods Clinical data and MR data of 210 HFS patients were reviewed retrospectively and then were compared with the operation results. Results MRTA presented a total of 215 symptomatic sides in the 210 HFS patients,including 5 patients with bilateral symptoms. There were 109 symptomatic sides with vascular compression on facial nerves,86 with neurovascular contacts,and 9 with dubious contacts,implying that the positive rate reached 94. 9%. Among the 205 healthy sides,12 were identified with vascular compression,23 with neurovascular contacts, and 6 with dubious contacts, indicating that the positive rate was 20%. The anatomical relationship between the facial nerves and the adjacent blood vessels had statistically significant difference between the symptomatic sides and the healthy ones in the HFS patients,and there was a positive correlation between the symptoms and neurovascular contacts or vascular compression on the facial nerves( P 〈 0. 01). Of 80 surgical patients,78 patients were found with vascular compression or neurovascular contacts,and 2 patients had no responsible vessels. The preoperative MRTA results of 71 patients were in complete accordance with the results found in the surgery. And among 4 patients with negative results of MRTA,3 were found with vein responsible vessels. With the operation results as the gold standard,the sensitivity and the diagnostic accordance rate of MRTA were 96. 2% and 95. 0%,respectively. Conclusion MRTA is a non-invasive and effective method for diagnosing the reasons of HFS before the operation. The spatial relationship between the facial nerves and the adjacent blood vessels can be clearly represented,and reliable imaging evidences can be provided for the diagnosis and treatmen
出处 《第三军医大学学报》 CAS CSCD 北大核心 2015年第12期1272-1276,共5页 Journal of Third Military Medical University
关键词 面肌痉挛 磁共振断层血管成像 血管压迫 hemifacial spasm magnetic resonance tomographic angiography vascular compression
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