[1]张伟,周小熳,聂耳,等.三叉神经痛影像学检查结果与微血管减压术疗效分析[J].临床神经外科杂志,2018,15(05):337-345.[doi:10.3969/j.issn.1672-7770.2018.05.005]
 ZHANG Wei,ZHOU Xiao-man,NIE Er,et al.Preoperative imaging of trigeminal neuralgia and microvascular decompression outcome[J].Journal of Clinical Neurosurgery,2018,15(05):337-345.[doi:10.3969/j.issn.1672-7770.2018.05.005]
点击复制

三叉神经痛影像学检查结果与微血管减压术疗效分析()
分享到:

《临床神经外科杂志》[ISSN:1672-7770/CN:32-1727/R]

卷:
15
期数:
2018年05期
页码:
337-345
栏目:
功能神经外科专题
出版日期:
2018-10-15

文章信息/Info

Title:
Preoperative imaging of trigeminal neuralgia and microvascular decompression outcome
作者:
张伟周小熳聂耳谷佳张旭
221000 徐州,徐州矿务集团第二医院神经外科(张伟);徐州医科大学研究生学院(周小熳);徐州医科大学附属医院神经外科(聂耳,谷佳,张旭)
Author(s):
ZHANG WeiZHOU Xiao-manNIE Eret al.
Department of Neurosurgery,Second Hospital of Xuzhou Mining Group,Xuzhou 221000 ,China
关键词:
三叉神经痛显微血管减压术磁共振体层血管成像
Keywords:
trigeminal neuralgia microvascular decompression surgerymagnetic resonance tomography angiography
分类号:
R745.1
DOI:
10.3969/j.issn.1672-7770.2018.05.005
文献标志码:
A
摘要:
目的 探讨原发性三叉神经痛影像学检查结果对微血管减压(microvascular decompression,MVD)术的指导意义。方法 回顾分析徐州医科大学附属医院神经外科2014年1月至2016年12月,MVD术治疗83例原发性三叉神经痛患者的临床资料。结果 磁共振体层血管成像(magnetic resonance tomography angiography,MRTA)显示,三叉神经与周围血管关系紧密者75例,包括小脑上动脉、小脑前下动脉、小脑后下动脉、椎动脉及岩静脉等;三叉神经紧密伴行者71例;血管骑跨4例。其检查阳性率为90.4%,灵敏度为93.6%,特异度75.0%,正确率92.6%。对原发性三叉神经痛患者术后随访12~36个月[平均(22±2.5)个月]。术后早期(术后3个月)的治愈率高达81.9%,有效率92.8%;MRTA检查阳性患者的有效率为93.3%。术后晚期(术后12个月)的治愈率达87.5%,有效率为94.8%;MRTA检查阳性患者的有效率为96%。结论 MRTA检查不仅有助于继发性三叉神经痛的病因诊断,而且能够显示原发性三叉神经痛受压责任血管,对手术指导有重要意义。
Abstract:
Abstract:Objective To investigate the significance of preoperative imaging of trigeminal neuralgia and curative effect of microvascular decompression(MVD).Methods The clinical data of 83 patients with primary trigeminal neuralgia treated by MVD from January 2014 to December 2016 in Affiliated Hospital of Xuzhou Medical University were analyzed retrospectively.Results 83 cases with primary trigeminal neuralgia by magnetic resonance tomography angiography(MITA) showed close relationship between the trigeminal nerve and peripheral blood vessels in 75 cases,including the trigeminal nerve with the small artery in 71 cases,blood vessels ride 4 and tortuous basilar artery in 1.The examination positive rate was 90.4%,93.6% in sensitivity,75.0% in specificity and the correct rate was 92.6%.Patients with primary trigeminal neuralgia were followed up for 12 to 36 months (mean 22±2.5 months),postoperative early (after 3 months) the cure rate was as high as 81.9%,the effective rate was 92.8%,postoperative late(after 12 months) the cure rate was as high as 87.5%,the effective rate was 94.8%,the effect was significant.Conclusions Magnetic resonance tomography angiography is not only helpful for the diagnosis of secondary causes of trigeminal neuralgia,but also for the responsible vessel of compression of primary trigeminal neuralgia,which is of great significance for surgical guidance.MVD is currently an effective treatment for trigeminal neuralgia.

相似文献/References:

[1]周勇智,邹元杰,刘永,等.三叉神经根入脑干区MRI形态学研究[J].临床神经外科杂志,2014,(01):29.
[2]胡文瀚,王新生.内镜在显微血管减压术中安全性和有效性的系统回顾[J].临床神经外科杂志,2015,(02):81.
[3]叶远良,王伟君,罗毅.影响微血管减压术治疗原发性三叉神经痛疗效相关因素分析[J].临床神经外科杂志,2015,(02):85.
[4]荣道建,杨晓健,赵俊伟.神经内镜辅助原发性三叉神经显微血管减压术[J].临床神经外科杂志,2015,(02):89.
[5]乔梁,朱宏伟,陶蔚,等.神经导航下三叉神经半月节射频热凝术中的电生理研究[J].临床神经外科杂志,2014,(02):107.
[6]李强,李玉,邓兴力.原发性三叉神经痛临床应用治疗进展[J].临床神经外科杂志,2014,(05):393.
[7]张施远,曾春,石海平,等.三叉神经痛微血管减压术后疗效及[J].临床神经外科杂志,2016,(02):106.
 ZHANG Shi-yuan,ZENG Chun,SHI Hai-ping,et al.Efficacy of MVD for trigeminal neuralgia and related complications[J].Journal of Clinical Neurosurgery,2016,(05):106.
[8]宋昭,刘如恩,夏小雨,等.枕下乙状窦后入路手术治疗三叉神经痛的术式选择[J].临床神经外科杂志,2016,(06):459.
 SONG Zhao,LIU Ru-en,XIA Xiao-yu,et al.Option of surgical treatment of trigeminal neuralgia with suboccipital retrosigmoid approach[J].Journal of Clinical Neurosurgery,2016,(05):459.
[9]刘厚强,于如同,丁允波,等.3D-FIESTA联合3D-TOF MRA对三叉神经微血管减压术的指导价值[J].临床神经外科杂志,2017,14(03):212.
 LIU Hou-qiang,YU Ru-tong,DING Yun-bo,et al.The value of 3D-FIESTA combined with 3D-TOF MRA sequence to the operation of microvascular decompression[J].Journal of Clinical Neurosurgery,2017,14(05):212.
[10]杨德宝,周世军,王安琪,等.悬吊技术在面肌痉挛显微血管减压术中的应用[J].临床神经外科杂志,2018,15(03):200.
 YANG De-bao,ZHOU Shi-jun,WANG An-qi,et al.Application of hanging techniques in microvascular decompression for hemifacial spasm[J].Journal of Clinical Neurosurgery,2018,15(05):200.
[11]王杨灵犀,王翀.三叉神经显微血管减压术中对岩上静脉的处理方式及并发症的影响[J].临床神经外科杂志,2019,16(2):147.[doi:10.3969/j.issn.1672-7770.2019.02.011]
 WANG Yang-ling-xi,WANG Chong..Management of superior petrosal vein and its complications during microvascular decompression of trigeminal nerve[J].Journal of Clinical Neurosurgery,2019,16(05):147.[doi:10.3969/j.issn.1672-7770.2019.02.011]

更新日期/Last Update: 2018-10-10