陈敏洁,张伟杰,杨驰,董敏俊,柴盈,张文豪.磁共振断层血管成像仪在三叉神经痛微血管减压术中的应用研究[J].口腔材料器械杂志,2013,22(1):33-37.
磁共振断层血管成像仪在三叉神经痛微血管减压术中的应用研究
Evaluation of magnetic resonance tomographic angiography in microvaslular decompression for trigeminal neuralgia
投稿时间：2012-08-23  修订日期：2013-01-14
DOI：10.11752/j.kqcl.2013.01.07
中文关键词:  三叉神经痛  磁共振断层血管成像  微血管减压术  手术指征
英文关键词:Trigeminal neuralgia  Magnetic resonance tomography  Microvascular decompression  Surgery indication
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作者单位E-mail
陈敏洁 上海交通大学医学院附属第九人民医院口腔医学院口腔颌面外科, 上海市口腔医学重点实验室  
张伟杰 上海交通大学医学院附属第九人民医院口腔医学院口腔颌面外科, 上海市口腔医学重点实验室 zwj1891502@sina.com 
杨驰 上海交通大学医学院附属第九人民医院口腔医学院口腔颌面外科, 上海市口腔医学重点实验室  
董敏俊 上海交通大学医学院附属第九人民医院放射科, 上海 200011  
柴盈 上海交通大学医学院附属第九人民医院口腔医学院口腔颌面外科, 上海市口腔医学重点实验室  
张文豪 上海交通大学医学院附属第九人民医院口腔医学院口腔颌面外科, 上海市口腔医学重点实验室  
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中文摘要:
      目的：检验磁共振断层血管成像(MRTA)对判断血管神经压迫(NVC)程度的准确性,评价其对微血管减压(MVD)手术适应证判断的指导价值。方法：对322例原发性三叉神经痛的患者行MVD。根据患者术前MRTA表现对NVC分级,并与术中NVC对比,采用Kappa(SPSS14.0)检验术前MRTA与术中NVC的一致度。根据术后随访情况将疗效分级,并分析术前不同NVC分级的患者术后疗效的差异。结果： 322例患者术前MRTA提示的NVC情况与术中表现无明显差异(x2=6.182,P=0.103>0.05),两者具有较高一致度(Kappa=0.811)。术后随访,277例患者(86.0%)术后疗效为优,27例患者(8.4%)为良,18例(5.6%)为差。术前NVC 0-1级的患者MVD有效率(疗效为优)81.8%(95/116),术后NVC 2-3级的患者有效率为88.3%(182/206)。结论：术前MRTA提示神经受压较为严重的患者(NVC 2级和3级)MVD术后获得较好疗效,为MVD的明确手术指征。
英文摘要:
      Objective: To evaluate the accuracy of magnetic angiography(MRTA) on determining the degree of vascular nerve compression (NVC),as well as the value to indicate microvascular decompression (MVD). Methods: 322 patients with primary trigeminal neuralgia (TN) came to the outpatient clinic from 2003 to 2011 were enrolled in the study and treated with MVD. The degree of NVC was graded according to MRTA finding before surgery, and were compared with that of NVC found in surgrey. The consistency of the NVC's degrees was statistically verified with Kappa test provided by SPSS 14.0 software. The surgical outcome were graded according to the follow一up and were analyzed among patients of different NVC grades. Results: No significant difference was found between the NVC degrees defined by presurgery MRTA and surgery findings (x2=6.182,p=0.103>0.05),and these two NVC degrees were highly consistent (kappa= 0.811). Following MVD,277 cases(86.0%)graded excellent,27 cases(8.4%)graded good and 18 cases (5.6%)graded poor. The success rate was 81.8% (95 out of 116)for grade 0-1 NVC and 88.3% (182 out of 206)for grade 2-3 NVC. Conclusions: The patients with severe NVC (grade 2-3 according to presurgery MRTA) were recommended to receive MVD.
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