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目的:评价磁共振T1加权三维选择性水激发(MR T1W 3D-WATS)成像在颅内血管压迫性三叉神经痛诊断中的应用价值。方法:14例三叉神经痛患者和6名正常志愿者行MR T1W 3D-WATS扫描及多平面重组,观察三叉神经与邻近血管的关系。结果:MRI示14例三叉神经痛患者中,单侧三叉神经受压右侧2例、左侧6例;双侧均受压5例,其中1例为双侧疼痛,仅有右侧或左侧疼痛的单侧疼痛各2例;1例患者两侧三叉神经均未见明显受压,但临床有明显右侧三叉神经痛症状。志愿者中,有受压现象者左、右侧各1例。三叉神经受颅内血管压迫与临床表现有明显相关性(P=0.03,r=0.84)。责任血管分别为小脑上动脉13/19支,小脑前下动脉1/19支,基底动脉1/19支,起源不清血管4/19支。结论:MR T1W 3D-WATS成像能够清楚显示三叉神经与邻近血管的关系,为临床颅内血管压迫性三叉神经痛的诊断提供依据。
Objective: To evaluate the value of MR T1W 3D-WATS imaging in the diagnosis of intracranial vascular compression trigeminal neuralgia. Methods: MR T1W 3D-WATS and multiplanar reconstruction were performed in 14 patients with trigeminal neuralgia and 6 normal volunteers. The relationship between the trigeminal nerve and the adjacent blood vessels was observed. Results: MRI showed that in 14 cases of trigeminal neuralgia, unilateral right trigeminal nerve compression in 2 cases, left in 6 cases; bilateral compression in 5 cases, including 1 case of bilateral pain, only the right or left Side pain 2 cases of unilateral pain; 1 case of patients with no significant trigeminal nerve compression, but the clinical manifestations of right trigeminal neuralgia symptoms. Among the volunteers, there were 1 patient on the left and the right on the pressure side. Trigeminal nerve by intracranial vascular compression and clinical manifestations have a significant correlation (P = 0.03, r = 0.84). The responsible vessels were 13/19 branches of the superior cerebellar artery, 1/19 branch of the anterior inferior cerebellar artery, 1/19 branch of the basilar artery, and 4/19 vessels of unknown origin. Conclusion: MR T1W 3D-WATS imaging can clearly show the relationship between the trigeminal nerve and adjacent blood vessels, and provide a basis for the diagnosis of intracranial vascular compression trigeminal neuralgia.