摘要
目的探讨原发性三叉神经痛(primary trigeminal neuralgia,PTN)患者MRI检测脑池段三叉神经形态学的改变。方法选择本院2016年8月~2019年3月收治PTN患者75例为研究对象,另外选取同时期75例健康志愿者作为对照。使用3D-FIESTA序列对两侧三叉神经脑池段进行扫描,图像扫描处理使用Reformat软件,记录三叉神经脑池段的长度及各个方位(矢状位、冠状位、轴位)上三叉神经脑池段的最大横截面积。检测三叉神经根岩尖处转角、血管压迫处距离三叉神经根部的距离以及脑桥和三叉神经的角度。结果对照组左右两侧脑池段的三叉神经长度比较,差异无统计学意义(P>0.05);左右两侧脑池段的三叉神经矢状位、冠状位及轴位最大横截面积比较,差异均无统计学意义(P>0.05);左右两侧脑池段的三叉神经与脑桥角度、神经根岩尖处转角比较,差异无统计学意义(P>0.05)。在PTN组中,患侧脑池段的三叉神经长度短于健侧,差异有统计学意义(P=0.005);患侧冠状位最大横截面积小于健侧,差异有统计学意义(P=0.000);患侧轴位位最大横截面积小于健侧,差异有统计学意义(P=0.000);患侧矢状位最大横截面积小于健侧,差异有统计学意义(P=0.000);患侧神经与脑桥角度与健侧比较,差异无统计学意义(P=0.923);患侧神经根岩尖处转角与健侧比较,差异无统计学意义(P=0.611)。PTN组患侧和健侧脑池段的三叉神经长度均短于对照组,差异有统计学意义(P<0.05);PTN组患侧和健侧脑池段的三叉神经冠状位最大横截面积均小于对照组,差异有统计学意义(P<0.05);PTN组患侧和健侧脑池段的三叉神经轴位最大横截面积均小于对照组,差异有统计学意义(P<0.05);PTN组患侧和健侧脑池段的三叉神经矢状位最大横截面积均小于对照组,差异有统计学意义(P<0.05);PTN组患侧和健侧脑池段的三叉神经与脑桥角度与对照组比较,差异无统计学意义(P>0.05);PTN组患侧和健侧脑池段的三叉神经根岩尖处转角与对照组比较,差异无统计学意义(P>0.05)。结论PTN患者脑池段三叉神经在MRI上会有明显改变,长度缩短以及各个方位上最大横截面积的变小,为PTN的诊断提供可靠的参考依据。
Objective To investigate the morphological changes of trigeminal nerve in the cistern of patients with primary trigeminal neuralgia(PTN)by MRI.Methods Seventy-five patients with PTN admitted to our hospital from August 2016 to March 2019 were selected as research subjects,and 75 healthy volunteers at the same period were selected as controls.Use 3 D-FIESTA sequence to scan the trigeminal nerve cistern on both sides.The image scanning process uses Reformat software to record the length of the trigeminal nerve cistern segment and the maximum cross-sectional area of the trigeminal nerve cistern segment in various directions(sagittal,coronal,and axial).The corner of the trigeminal nerve root rock tip,the distance from the vascular compression point to the trigeminal nerve root,and the angle of the pons and trigeminal nerve were detected.Results There was no statistically significant difference in the length of the trigeminal nerve between the left and right brain pools in the control group(P>0.05).There was no statistically significant difference in the sagittal,coronal,and axial cross-sectional areas of the trigeminal nerve between the left and right brain cistern segments(P>0.05);There was no statistically significant difference between the trigeminal nerve on the left and right sides of the brain cistern,the pons angle,and the nerve root rock tip angle(P>0.05).In the PTN group,the length of the trigeminal nerve in the affected cistern was shorter than that in the healthy side,the difference was statistically significant(P=0.005).The maximum cross-sectional area of the coronal position on the affected side is smaller than that on the healthy side,the difference is statistically significant(P=0.000);The maximum axial cross-sectional area of the affected side is smaller than the healthy side,and the difference is statistically significant(P=0.000);The maximum sagittal cross-sectional area of the affected side is smaller than that of the healthy side,and the difference is statistically significant(P=0.000);There was no statistically significant difference between the angle of the affected nerve and pontine compared with the healthy side(P=0.923).There was no statistically significant difference between the corner of the affected nerve root rock tip and the healthy side(P=0.611).The length of the trigeminal nerve in the affected side and the healthy side of the brain pool in the PTN group was shorter than that in the control group,the difference was statistically significant(P<0.05).The maximum cross-sectional area of the trigeminal nerve in the PTN group on the affected side and the healthy side of the brain pool is smaller than that in the control group,the difference is statistically significant(P<0.05);The maximum cross-sectional area of the trigeminal nerve axis in the affected and healthy brain pools of the PTN group was smaller than that of the control group,the difference was statistically significant(P<0.05).The sagittal maximum cross-sectional area of the trigeminal nerve in the PTN group on the affected side and the healthy side of the cistern was smaller than that in the control group,the difference was statistically significant(P<0.05).Compared with the control group,the angle of the trigeminal nerve and pontine in the PTN group’s affected and healthy sides of the cistern was not statistically significant(P>0.05).Compared with the control group,the angle of the trigeminal nerve root tip in the PTN group’s affected and healthy brain pool sections was not statistically significant(P>0.05).Conclusion MRI of the trigeminal nerve in the cistern of PTN patients will be significantly changed on MRI.The shortened length and the decrease of the maximum cross-sectional area in all directions provide a reliable reference for the diagnosis of PTN.
作者
崔二辉
徐欢
张楠
贾情
马树泽
赵大敏
Cui Erhui;Xu Huan;Zhang Nan(Department of Imaging,Shijiazhuang people's Hospital,Shijiazhuang,050000,China)
出处
《立体定向和功能性神经外科杂志》
2020年第3期136-140,共5页
Chinese Journal of Stereotactic and Functional Neurosurgery
基金
石家庄市科学技术研究与发展计划项目(编号:191460513)
作者简介
通讯作者:赵大敏,33104206@qq.com
