面神经脑池段与其周围血管的MRI重建观测及临床应用

doi:10.13418/j.issn.1001-165x.2018.01.005

中国临床解剖学杂志 ›› 2018, Vol. 36 ›› Issue (1): 17-21.doi: 10.13418/j.issn.1001-165x.2018.01.005

面神经脑池段与其周围血管的MRI重建观测及临床应用

苗莹莹¹，　吕方²，　侯明月³，　赵俊强¹，　付升旗³

1. 新乡医学院三全学院人体解剖学教研室；　2. 新乡医学院第三附属医院MRI室；　3. 新乡医学院解剖学教研室，新乡 453003

收稿日期:2017-09-08 出版日期:2018-01-25 发布日期:2018-03-06
通讯作者: 付升旗，教授，硕士生导师，E-mail: fushengqihappy@126.com
作者简介:苗莹莹（1983-），女，河南上蔡人，讲师，医学硕士，主要从事头颈部的断层影像解剖及临床应用研究，E-mail: myylove1983@163.com
基金资助:
河南省软科学研究计划（174200410495）

MRI reconstruction observation and clinical application of the cisternal segment of facial nerve with its surrounding vessels

MIAO Ying-ying¹, LV Fang², HOU Ming-yue³, ZHAO Jun-qiang¹, FU Sheng-qi³

1. Department of Anatomy, Sanquan College of Xinxiang Medical University; 2. Department of MRI, Third Affiliated Hospital of Xinxiang Medical University; 3. Department of Anatomy, Xinxiang Medical University , Xinxiang 453003, China

Received:2017-09-08 Online:2018-01-25 Published:2018-03-06

摘要/Abstract

摘要：

目的　为面神经脑池段与其周围血管是否存在压迫或接触提供形态学诊断依据。方法　选取采用MRI 3D-FIESTA和3D-TOF序列扫描的检查正常者140例和单侧面肌痉挛患者70例，在MPR重建影像上观测I-CSFN-SV的血管直径、与脑干距离和血管自身角度、夹角及其与面肌痉挛发病率之间的关系。结果　正常组、面肌痉挛健侧组和面肌痉挛患侧组I-CSFN-SV的血管直径、与脑干距离、血管自身角度、夹角分别为（0.48±0.03）mm、（0.49±0.04）mm、（0.71±0.06）mm和（8.69±0.62）mm、（8.66±0.75）mm、（5.93±0.47）mm，（74.39±2.33）°、（72.66±2.54）°、（48.57±3.28）°和（85.60±3.07）°、（86.75±2.73）°、（88.41±3.76）°，面肌痉挛患侧组与正常组、面肌痉挛健侧组I-CSFN-SV的血管直径、与脑干距离、血管自身角度均有显著性差异（P＜0.05），夹角无显著性差异（P＞0.05），且随着I-CSFN-SV与脑干距离的增加则发病率呈下降趋势，血管直径的增加和血管自身角度的减小则发病率呈上升趋势，夹角变化与发病率之间无显著性变化趋势。结论　I-CSFN-SV的血管直径、与脑干距离和血管自身角度是诊断是否存在压迫或接触的重要诊断指标，血管自身角度越小、血管直径越粗和相交处与脑干距离越近，则越容易出现面肌痉挛病变。

关键词: , 面神经, 　脑血管, 　MRI, 　多平面重组, 　面肌痉挛

Abstract:

Objective　To provide evidence for the morphological diagnosis on the oppression and contact of the cisternal segment of facial nerve with its surrounding vessels.　Methods　140 normal and 70 patients with unilateral hemifacial spasm were selected by MRI 3D-FIESTA and 3D-TOF sequence scanning. The following parameters were observed in the MPR reconstruction image, including the vascular diameter, distance to brainstem vascular self angle and included angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels, and its relationship with the morbidity of hemifacial spasm.　Results　The vascular diameter, distance to brainstem, vascular self angle and included angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels were (0.48±0.03)mm, (0.49±0.04)mm, (0.71±0.06) mm and (8.69±0.62) mm, (8.66±0.75)mm, (5.93±0.47) mm and (74.39±2.33) °, (72.66±2.54) °, (48.57±3.28) ° and (85.60±3.07) °, (86.75±2.73) °, (88.41±3.76) ° on the normal group, uninjured group of hemifacial spasm, ipsilateral group of hemifacial spasm， respectively. There were significant difference between the ipsilateral group of hemifacial spasm to the normal group, uninjured group of hemifacial spasm at the vascular diameter, to brainstem distance and vascular self angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels (P<0.05), there was no significant difference at the included angle(P>0.05). The morbidity decreased with the increase of intersection to brainstem distance, increased with the enlargement of vascular diameter and the reduction of vascular self angle. There was no significant change between the included angle to morbidity.　Conclusions　The vascular diameter, distance to brainstem and vascular self angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels are important diagnostic markers whether the oppression or contact exists. The lesser of the vascular self angle, the larger of the vascular diameter and the shorter of the distance between the intersection and brainstem, the more prone the patient is to hemifacial spasm lesions.

Key words: Facial nerve, 　Brain vessel, 　Magnetic resonance imaging, 　Multiplanar reconstruction, 　Hemifacial spasm

苗莹莹,吕方,侯明月,赵俊强,付升旗. 面神经脑池段与其周围血管的MRI重建观测及临床应用[J]. 中国临床解剖学杂志, 2018, 36(1): 17-21.

MIAO Ying-ying, LV Fang, HOU Ming-yue, ZHAO Jun-qiang, FU Sheng-qi. MRI reconstruction observation and clinical application of the cisternal segment of facial nerve with its surrounding vessels[J]. Chinese Journal Of Clinical Anatomy, 2018, 36(1): 17-21.

参考文献

[1] Auger RG, Whisnant JP. Hemifacial spasm in Rochester and Olmsted County, Minnesota, 1960 to 1984 [J]. Arch Neurol, 1990, 47(11): 1233-1234.
[2] 刘清军, 张云鹤, 朱军, 等. 面肌痉挛微血管减压术中监测异常肌电反应的作用 [J]. 天津医科大学学报, 2010, 16(3): 264-266.
[3] Zhu J, Li ST, Zhong J, et al. Role of arterioles in management of microvascular decompression in patients with hemifacial spasm [J]. J Clin Neurosci, 2012, 19(3): 375-379.
[4] Hatipoglu HG, Durakoglugi1 T, Ciliz D, et a1. Comparison of FSE T2 and 3D-FIESTA sequences in the evaluation of posterior fossa cranial nerves with MR cisternography[J]. Diagn Interv Radiol, 2007, 13(2): 56-60.
[5] Jannetta PJ, Abbasy M, Maroon JC, et al. Etiology and definitive microsurgical treatment of hemifacial spasm: operative techniques and results in 47 patients [J]. J Neurosurg, 1977, 47(3): 321-328.
[6] 郑红伟, 祁佩红, 薛鹏, 等. 3.0T MR 3D-FIESTA +C成像序列结合多平面重建对I-XII对脑神经脑池段的成像研究[J]. 实用放射学杂志, 2012, 28(6): 849-852.
[7] Tomii M, Onoue H, Yasue M, et a1. Microscopic measurement of the facial nerve root exit zone from central glial myelin to peripheral schwann cell myelin [J]. J Neurosurg, 2003, 99(2): 121-124.
[8] 胡辉军, 王东烨, 曾伟科, 等. 小脑下前动脉的64层螺旋CT血管造影评价[J]. 岭南急诊医学杂志, 2015, 20(6): 495-497.
[9] 郭若泪, 李庆玲, 陈少琼, 等. 小脑下后动脉的320排CT血管造影形态学分析[J]. 实用放射学杂志, 2012, 28(9): 1319-1322.
[10] Shimanskii VN, Karnaukhov VV, Sergienko TA, et al. Endoscopic assistance in microvascular decompression of cranial nerves [J]. Zh Vopr Neirokhir Im N N Burdenko, 2012, 76(2): 3-10.
[11] 韩晓红，李晓鹏, 李培, 等. 大脑中动脉M1段的显微解剖与血管造影对照观测及临床意义[J]. 中国临床解剖学杂志, 2013, 31(2): 154-157.
[12] 陈彤，徐涛, 戎伯英, 等. 小脑下后动脉的显微解剖研究[J]. 中国微侵袭神经外科杂志, 2006, 11(6): 267-268.
[13] Ying T, Thirumala P, Chang Y, et al. Emprical factors associated with brainstem auditory evoked potential monitoring during microvascular decompression for hemifacial spasm and its correlation to hearing loss[J]. Acta Neurochir, 2014, 156(3): 571-575.
[14] 胡昊, 吴飞云, 许晓泉, 等. 磁共振3D-SPACE序列对血管压迫性面肌痉挛的诊断价值[J]. 实用放射学杂志, 2014, 30(2): 203-206.

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面神经脑池段与其周围血管的MRI重建观测及临床应用

MRI reconstruction observation and clinical application of the cisternal segment of facial nerve with its surrounding vessels

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