摘要
目的:探讨磁共振成像的飞行时间(TOF)序列联合稳态构成干扰(CISS)序列对微血管减压术术前血管接触情况的诊断价值。方法:选取医院收治的98例三叉神经痛并行微血管减压术患者,采用手术录像和磁共振TOF序列、CISS序列记录患者术前血管接触情况,采用TOF序列、CISS序列和TOF序列联合CISS序列的3种诊断方法,对血管接触的情况分别与手术录像镜下所得结果进行对比分析。结果:手术录像确认96例存在血管接触,其中单根血管接触47例,复合血管接触49例,另有2例无明显血管接触。在手术前,TOF序列联合CISS序列诊断灵敏度显著高于TOF序列,特异度显著低于TOF序列,两种方法比较差异有统计学意义(x^2=9.77,x^2=6.95;P<0.05);两种检测方法的准确率比较,其差异无统计学意义(x^2=0.92,P>0.05)。在手术中,TOF序列联合CISS序列诊断灵敏度和准确率均显著高于TOF序列,3种检验方法比较,其差异有统计学意义(x^2=11.36,x^2=8.73;P<0.01)。3种诊断方法判断小脑上动脉、单纯静脉和复合血管接触的血管类型吻合率比较,其差异均无统计学意义(x^2=0.39,x^2=0.25,x^2=0.03;P>0.05)。结论:磁共振TOF序列联合CISS序列可有效判断微血管减压术前是否存在血管接触,但无法判定血管来源,对手术具有一定的指导意义。
Objective:To explore the diagnostic value of magnetic resonance time of flight(TOF)sequence combined with constructive interference in steady state(CISS)sequence for preoperative vascular contact of microvascular decompression operation.Methods:98patients with prosopalgia who were implemented microvascular decompression operation were enrolled in this study.The situations of vascular contact were recorded by using surgical video,magnetic resonance TOF sequence and CISS sequence.Three diagnosis methods(TOF sequence,CISS sequence,and the TOF sequence combined with CISS sequence)were respectively adopted to compared with the results of surgical video for the situation of vascular contact.Results:As the confirmation of surgical video,96cases existed the vascular contact.And in these cases,47cases were single vascular contact,and49cases were composite vascular contact,and other2cases were no obvious vascular contact.The diagnosis sensitivity of the combination of TOF sequence and CISS sequence was significantly higher than that of TOF sequence(x2=9.77,P<0.05),and its specificity was significantly lower than that of TOF sequence(x2=6.95,P<0.05)in pre-operation,and the difference of accuracy rate between the two methods were no significant(x2=0.92,P>0.05).The diagnosis sensitivity and accuracy rate of the combination of TOF sequence and CISS sequence were significantly higher than that of TOF sequence during operation,and the differences of diagnosis sensitivity and accuracy rate among three methods were statistically significant,respectively(x2=11.36,x2=8.73,P<0.01).The coincidence rates of arteria cerebelli superior,vein and composite vascular contact among three methods were no statistically significant(x2=0.39,x2=0.25,x2=0.03,P>0.05),respectively.Conclusion:Magnetic resonance TOF sequence combined with CISS sequence can effectively determine whether there is vascular contact before microvascular decompression operation,although it can't determine the source of blood vessels.Therefore,this method has a certain guiding significance for operation.
作者
袁有法
房星宇
张艺军
张宝性
刘琳
YUAN You-fa;FANG Xing-yu;ZHANG Yi-jun(Department of Radiotherapy, The 305th Hospital of PLA, Beijing 100017, China)
出处
《中国医学装备》
2017年第11期54-57,共4页
China Medical Equipment
作者简介
袁有法,男,(1972- ),本科学历，副主任技师。解放军第305医院放射科，研究方向：影像技术。;通讯作者：zhangyijundoctor@163.com
