磁共振仿真内窥镜技术在前庭蜗神经微血管压迫综合征中的应用价值_李善杰

中国临床神经外科杂志2013年4月第18卷第04期Chin J Clin Neurosurg ，April 2013，Vol.18，No.4

【摘要】目的探讨磁共振仿真内窥镜技术（MRVE ）在前庭蜗神经微血管压迫综合征中的应用价值。方法回顾性分析2011年2月至2012年10月行MRI 检查的397例患者的影像学资料，利用MRVE 显示前庭蜗神经和周围微血管关系，结合多平面重建技术（MPR ）进行综合分析。结果MPR 显示，有微血管存在但无神经压迫的41例中，MRVE 显示6例为可疑压迫，35例无压迫；MPR 显示存在神经压迫或接触241例，与MRVE 显示的一致；MPR 显示的可疑神经压迫或接触135例中，MRVE 显示99例存在压迫或接触，36例可疑有压迫。MRVE 与MPR 诊断一致的312例，符合率78.59%。但MRVE 可对神经微血管进行三维立体显示。结论MRVE 作为一种无创的成像方式，可直观的显示前庭蜗神经和周围微血管的关系以及血管走形方式，为临床术前评估和术中指导提供重要的影像学依据。但在显示前庭蜗神经和微血管间距上存在一定的不足，需结合MPR 进行综合分析。

【关键词】神经压迫综合征；仿真内窥镜；磁共振成像；前庭蜗神经【文章编号】1009-153X （2013）04-0212-002

【文献标志码】A

【中国图书资料分类号】R 745.4+9

Value of MR virtual endoscopy to diagnosis and treatment of vestibulocochlear nerve compression syndrome

LI Shan-jie 1,CHEN Wei-Liang 1,ZHANG Xiao-lin 1,CHEN Yang-yang 2,YUAN Xiao-dan 1,ZHU Qian 1.1.Imaging Center,The 371st Central Hospital,PLA,Xinxiang 453000,China;2.Department of Radiology,The First Affiliated Hospital,Xinxiang Medical University,He ’nan Weihui 453100,China

【Abstract 】Objective To explore the value of MR virtual endoscopy (MRVE)to the diagnosis and treatment of the

vestibulocochlear nerve compression syndrome.Methods MRVE was performed in order to show the relationship between the vestibulocochlear nerves and blood vessels around the vesibulocochlear nerves in 397patients with vestibulocochlear nerve compression

syndrome who also be examinated by 3D-SPACE sequence in order to obtain the multi-planar reconstruction (MPR)imagings.All the imaging data were analyzed and compared in order to find out the advantages of MRVE.Results MRVE showed that of 41patients without nerve compression shown by MPR,6had suspectable nerve compression and 35not.Both the MRVE and MPR showed that 241patients had nerve compression.MRVE showed that of 135patients with suspected nerve compression shown by MPR,36had suspected

nerve compression and 99had nerve compression.The diagnosis made by MRVE accorded with that made by MPR in 312patients (78.59%)and three-dimensional images of the nerves and blood vessels were shown by MRVE.Conclusions The MRVE,which is a noninvasive imaging method,can objectively show the relationship between the vestibulocochlear nerves and microvessels around them and microvascular run,and may provide an important basis for the clinical preoperative assessment and intraoperative treatment of vestibulocochlear nerve compression syndrome.But there are some deficiencies in displaying the distances between the

vestibulocochlear nerves and microvessels around them,which need to be comprehensively assessed by MRVE combined with MPR.

【Key words 】Virtual endoscopy;Magnetic resonance imaging;Microvascular compression;Vestibulocochlear compression

syndrome

磁共振仿真内窥镜技术在前庭蜗神经微血管压迫

综合征中的应用价值

李善杰

陈维亮

张小林

陈阳阳

苑晓丹

朱倩

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论著

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微血管压迫前庭蜗神经导致眩晕、耳鸣、听力障碍等在临床上比较常见，前庭蜗神经及微血管的显示得到临床的逐步重视，前庭蜗神经与血管交叉压

迫的治疗取得了重大进展[1，2]

。很多学者利用磁共振对前庭蜗神经周围解剖关系进行了初步研究，但对

前庭蜗神经微血管的三维立体成像研究少有报道。

本文利用磁共振仿真内窥镜成像技术（MR virtual endoscopy,MRVE ）对前庭蜗神经及其周围微血管进行三维成像，以给临床更直观的影像资料。1资料与方法

1.1研究对象2011年2月至2012年10月在我院进行前庭蜗神经1.5T 磁共振高分辨检查的患者397例，其中男215例，女182例；年龄25~69岁，平均

51.2岁。患者主要表现为耳鸣、眩晕、面肌痉挛，伴

doi:10.3969/j.issn.1009-153X.2013.04.008

作者单位：453000河南新乡，解放军第371中心医院影像中心（李善杰、陈维亮、张小林、苑晓丹、朱倩）；453100河南卫辉，新乡医学院

第一附属医院放射科（陈阳阳）

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