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1、磁共振断层血管成像对三叉神经痛病因诊断价值【摘要】目的探讨磁共振断层血管成像(MRTA)对三叉神经痛(TN)病因诊断的临床应用价值。方法TN患者45例及健康成人(对照组)20例，行MRTA检查，观察3DT0F成像序列结合3DCISS序列中脑桥小脑角池内三叉神经与周管的关系，并与手术结果进行盲法对照。结果TN组患侧神经血管存在接触或压迫41例，健侧存在血管接触或压迫9例,对照组40侧有10侧显示神经血管接触或压迫。TN组患侧神经血管接触或压迫的阳性率与健侧及对照组比较差别有统计学意义(P<0.05),健侧和对照组的差别无统计学意义(P>0.05)oMRTA对神经血管接触或压迫的敏感度、特异度
2、、准确度、阳性预测值、阴性预测值、阳性似然比、阴性似然比、约登指数分别为93.75%,81.82%,88.89%,88.24%,90%,5.16,0.077,0.76。结论MRTA诊断CPA池内血管接触或压迫敏感度和真实性高,为尽早合理治疗提供客观的影像学依据。【关键词】三叉神经痛磁共振血管血管造影术诊断ABSTRACT：ObjectiveToexplorethevalueofMRtomographicangiography(MRTA)intheetiologicaldiagnosisoftrigeminalneuralgia(TN)・MethodsFortyfivepatientswit
3、hTNand20healthycontrolsunderwentMRTA・Therelationshipofthefifthcranialnervetoadjacentvesselswasbestvisualizedonthethreedimensionaltimeofflightmagneticresonanceangiography(3DTOFMRA),andconstruetiveinterferenceatsteadystate(CISSMR)sequences・TheresultsfromMRTAwerecomparedwiththeoutcomeofMVD.ResultsNeu
4、rovascularcontact/compress(NVC)wasverifiedin41of45symptomaticsides,in9of45oppositesidesand10of40controlsides.ThepositiverateofNVCinsymptomaticsidesweresignificanthigherthanthatintheoppositesidesandthecontrolgroup(P<；0.05),nosignificantdifferencewasfoundbetweentheoppositesidesandthecontrolgroup(P
5、>；0.05).Evaluatin百theMRTAdiagnosisofNVC：thesensitivityratewas93.75%,thespecificityratewas81.82%,theaccuracyratewas88.89%,thepositivepredictivevaluewas88.24%,thenegativepredictivevaluewas90%,thepositivelikelihoodratiowas5・16,thenegativelikelihoodratiowas0.077,YoudenSindexwas0.76.ConclusionMRTAdem
6、onstratesthatneurovascularcontact/compressattherootentryzonesincasesofTN.Thesefindingswereverifiedatsurgery.ThespecificityandaccuracyindiagnosisofNVCbyMRTAarehigh・MRTAcanshowtheanatomicalrelationshipaccurately,whichisbeneficialforclinictreatment・KEYWORDS：trigeminalneuralgia；neurovascularcontact/co
7、mpression；MRTA关于三叉神经痛(trigeminalneuralgia,TN)的病因和发病机制，学术界尚存争论。目前国际上的研究集中于神经血管接触/压迫(neurovascularcontact/compression,NVC)学说。笔者应用磁共振断层血管成像三维时间飞越法(threedimensionaltimeofflight,3DTOF)结合三维稳态构成干扰序列(threedimensionalcons
