摘要
目的探讨扩散张量成像(DTI)对糖尿病三叉神经痛(TN)的诊断价值。方法搜集50例糖尿病神经病变伴三叉神经痛(DN-TN)患者、50例糖尿病神经病变不伴三叉神经痛(DN-NTN)患者及50名健康对照组(HC)志愿者,分别行三叉神经三维时间飞跃法(3D-TOF)、三维可变翻转角快速自旋回波(3D-SPACE)、DTI并测量三叉神经脑池段长度、三叉神经脑桥角、入脑干处截面积、桥小脑角池面积、各向异性分数(FA)和表观扩散系数(ADC)值,采用t检验进行组间比较。结果DN-TN较DN-NTN与HC比较,FA中,DN-TN 0.10±0.04较DN-NTN 0.39±0.05及HC 0.48±0.03明显减小,ADC值中,DN-TN(2.01±0.21)×10^-3mm^2/s较DN-NTN(1.64±0.19)×10^-3mm^2/s及HC(1.51±0.10)×10^-3mm^2/s明显增大,FA及ADC值具有统计学差异(P<0.05);DN-NTN与HC比较FA值稍减低、ADC稍增高,但差异无统计学意义(P>0.05);三叉神经桥脑角以DN-NTN组患者均值最小47.32°±10.78°、HC均值最大48.34°±10.35°,三叉神经脑池段长度以DN-NTN组患者均值最短(8.47±0.28)mm、HC均值最长(8.59±0.35)mm,三叉神经入脑干处截面积以DN-TN组患者均值最大(5.79±1.86)mm^2、DN-NTN均值最小(5.52±1.28)mm^2,桥小脑角池面积以DN-TN组患者均值最大(276.53±73.51)mm^2、HC均值最小(247.21±48.79)mm^2,DN-TN、DN-NTN与HC三叉神经脑池段长度、三叉神经脑桥角、入脑干处截面积和桥小脑角池面积组间比较差异无统计学意义(P>0.05)。结论DN-TN患者三叉神经形态变化不明显,DTI中的FA值与ADC值可作为评估DN-TN的定量观察指标、对DN-TN具有一定的诊断价值。
Objective to evaluate the diagnostic value of DTI imaging in diabetic trigeminal neuralgia(TN).Methods Fifty patients with diabetic neuropathy accompanied by trigeminal neuralgia(DN-TN),50 patients with diabetic neuropathy without trigeminal neuralgia(DN-NTN)and 50 healthy controls(HV)were enrolled.Three-dimensional TOF,three-dimensional SPC and DTI imaging of trigeminal nerve were performed,and the length of cistern segment of trigeminal nerve,pontine angle of trigeminal nerve,cross-sectional area of entrance brainstem,and so on were measured.(Three-dimensional TOF,three-dimensional SPC and DTI imaging of trigeminal nerve were performed,and the length of cistern segment of trigeminal nerve,pontine angle of trigeminal nerve,cross-sectional area of entrance brainstem,the area of cerebellopontine cistern,fractional anisotropy(FA)and apparent diffusion coefficient(ADC)were measured.)All the parameters of three groups were compared by t test.Results In the group of Fractional anisotropy(FA)Compared with DN-NTN and HV,DN-TN(0.10±0.04)was significantly lower than DN-NTN(0.39±0.05)and HV(0.48±0.03),and the apparent diffusion coefficient(ADC)value group,DN-TN(2.01±0.21)was significantly higher than DN-NTN(1.64±0.19)and HV(1.51±0.10),and the FA and ADC values were statistically significant difference(P<0.05);compared with HV,the FA value of DN-NTN was slightly lower,the ADC value was slightly incresed,but there was no significant difference(P>0.05);The mean value of the pontine angle of trigeminal nerve was the lowest in DN-NTN group(47.32°±10.78°),and the highest in HV group(48.34°±10.35°),The mean value of the length of the cistern of the trigeminal nerve was the shortest(8.47±0.28)mm and the longest(8.59±0.35)mm in the DN-NTNgroup,The mean value of the cross-sectional area of the trigeminal nerve into the brainstem was the largest(5.79±1.86)mm^2 and the smallest(5.52±1.28)mm^2 in the DN-TN group,and The mean value of the area of the cerebellopontine angle cistern was the largest(276.5±73)mm^2 in the DN-TN group.There was no significant difference among DN-TN,DN-NTN and HV in the length of trigeminal cistern,pontine angle,cross-sectional area of brain stem and cistern area of cerebellopontine angle(P>0.05).Conclusion The morphological changes of trigeminal nerve in DN-TN patients are not obvious.FA and ADC values in DTI can be used as quantitative observation indexes for evaluating DN-TN and have certain diagnostic value for DN-TN.
作者
王军大
杨华
方玉
任何
姜洋
李艳艳
WANG Junda;YANG Hua;FANG Yu(Department of Radiology,Chongqing Chinese Medicine Hospital,Chongqing 400021,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第9期1684-1688,共5页
Journal of Clinical Radiology
基金
重庆市2018年科卫联合中医药科技项目(编号:ZY201802025)
重庆市基础研究与前沿探索专项(自然科学基金)(编号:cstc2019jcyj-msxmX0555)
“杏林学者”学科人才科研提升计划(编号:YYZX2019064)
