摘要
目的探讨3.0T MR三维时间飞跃（3D-TOF）序列与三维稳态采集快速成像（3D-FIESTA）序列融合图像在三叉神经微血管减压术术前评估中的应用价值。方法回顾性分析31例经微血管减压术治疗的原发性三叉神经痛患者的病例资料,术前均行3D-TOF序列、3D-FIESTA序列检查。由两名5年以上工作经验的放射科诊断医师,采用双盲法分别对3D-TOF序列重组所得多平面图像（A组）及3D-TOF序列与3D-FIESTA序列融合图像（B组）对脑池段神经血管关系的显示情况进行评判,并采用Kappa分析对两名医师的主观评判结果行一致性评价。采用χ~2检验比较A、B组图像对脑池段神经血管关系显示情况的差异。以手术探查结果为金标准,分别计算A、B组诊断神经血管关系的敏感度、特异度、准确度、阳性预测值和阴性预测值,采用χ~2检验比较A、B组诊断神经血管关系的敏感度、特异度、准确度、阳性似预测值和阴性预测值的差异。结果两名医师对A、B组图像显示脑池段神经血管关系主观评判的Kappa值分别为0.691、0.931（检验水准α=0.05）,B组的一致性优于A组。A、B组图像对脑池段神经血管关系显示情况的差异有统计学意义（P=0.000,P〈0.05）。31例受检者术中发现有血管接触或压迫者共29例,A组诊断神经血管关系的敏感度、特异度、准确度和阴性预测值分别是90%（26/29）、50%（1/2）、87%（27/31）、25%（1/4）,B组诊断神经血管关系的敏感度、特异度、准确度和阴性预测值分别是97%（28/29）、100%（2/2）、97%（30/31）、67%（2/3）,均高于A组,且差异有统计学意义（P值分别为0.045、0.000、0.009和0.000,P〈0.05）。A、B组诊断神经血管关系的阳性预测值分别为96%（26/27）和100%（28/28）,差异无统计学意义（P=0.13,P〉0.05）。结论 3D-TOF序列与3D-FIESTA序列融合图像能清晰显示三叉神经与周围血管的空间关系,具有更高�
Objective To investigate the diagnostic value of the fusion imaging of 3 D-TOF and 3 D-FIESTA sequences in microvascular decompression for trigeminal neuralgia by 3. 0 T MR. Methods 31 cases of idopathic trigeminal neuralgia underwent microvascular decompression（ MVD） were retrospectively analyzed,all of them underwent 3 D-TOF and 3 DFIESTA sequences scans. Double blind method was used to evaluate the display relationship of trigeminal nerve and around vessels of 3 D-TOF combining with multiplanar reconstruction（ Group A） and 3 D-TOF fusion with 3 D-FIESTA（ Group B）was independently performed by two radiologists both with 5 years＇ experience and the agreement evaluation was performed using Kappa analysis. The χ~2 test was used to compare the differences between Group A and Group B images on the relationship between the cerebral vessels and the blood vessels in the brain. Using surgical results as the gold standard,the sensitivity,specificity,accuracy,positive predictive value（ PPV） and negative predictive value（ NPV） were calculated for Group A and Group B. The sensitivity,specificity,accuracy,positive predictive value（ PPV） and negative predictive value（ NPV） between the two groups were analyzed using the χ~2 test. Results The Kappa value of both groups was0. 691 and 0. 931 respectively（ α = 0. 05）,where the consistency of Group B was superior than Group A. The difference of Group A and Group B in show the relationship between the cerebral vessels and nerves was statistically significant（ P =0. 000,P 0. 05）. A total of 29 cases were found in 31 cases of vascular contact or compression,the sensitivity,specificity,accuracy and negative predictive value（ NPV） of Group A were 90%（ 26/29）,50%（ 1/2） 、87%（ 27/31）,25%（ 1/4）respectively,where the sensitivity,specificity,accuracy and negative predictive value（ NPV） of Group B were 97%（ 28/29）,100%（ 2/2）,97%（ 30/31）,67%（ 2/3） respectively,were superior than Group A,and the difference was sta
作者
郭田田
张秋妹
徐建
苗重昌
GUO Tiantian;ZHANG Qiumei;XU Jian;et al.(Department of Radiology, Affiliated Lianyungang Hospital of Xuzhou Medical University, Lianyungang 222002, P. R. Chin)
出处
《临床放射学杂志》
CSCD
北大核心
2018年第3期387-391,共5页
Journal of Clinical Radiology
基金
江苏省卫生科研项目(编号:Z201417)
关键词
三叉神经痛
磁共振成像
融合图像
微血管减压术
Trigeminal neuralgia Magnetic resonance imaging Fusion imaging Microvascular decompression
