党计锋 王伟霞 赵埴飚 潘兴利 贾耀

[摘要] 目的 探讨磁共振三维时间飞跃法扫描序列（3D-TOF）与容积内插屏气扫描序列（VIBE序列）对三叉神经痛（trigeminal neuralgia，TN）的诊断价值。方法 在该院2012年1月—2014年10月纳入96例确诊为三叉神经痛的患者，并采用3D-TOF序列与VIBE序列大、小体素模式对患者进行扫描，记录患者三叉神经周围的血管数目，计算并分析患者的SNR（图像信号噪声比）和CNR（对比噪声比）。 结果3D-TOF序列及VIBE序列直观地呈现了原始图像中难以明确判断的血管的走向及血管压迫与患者症状的关系，96例患者中，24例患者进行了手术治疗，其中，12例患者的责任血管位于右侧小脑的上动脉，9例患者位于小脑前的下动脉，3例患者位于右侧的小脑的上动脉桥静脉及前下动脉，且三叉神经存在血管压迫或接触90例，与周围血管无压迫或接触6例，阳性率为94%，同时，经3D-TOF序列扫描显示血管的数目少于VIBE序列扫描显示的数目， VIBE序列高于3D-TOF序列。结论 联合3D-TOF序列与VIBE序列可克服两种序列的缺点，提高神经血管的成像速度并明确分辨出不同大小和血流速度的责任动脉，对三叉神经痛的诊断具有较好的临床意义。

[关键词] 3D-TOF序列；VIBE序列；三叉神经痛；SNR；CNR

[中图分类号] R745.11 [文献标识码] A [文章编号] 1674-0742（2016）03（c）-0186-03

Value of Magnetic Resonance 3D-TOF Sequence and VIBE Sequence in Diagnosis of Prosopalgia

DANG Ji-feng， WANG Wei-xia， ZHAO Zhi-biao， PAN Xing-li， JIA Yao

MRI Room， Zoucheng General Hospital of Yankuang Group， Zoucheng， Shandong Province， 273500 China

[Abstract] Objective To discuss the value of magnetic resonance 3D-TOF sequence and VIBE sequence in diagnosis of prosopalgia. Methods 96 cases of patients with prosopalgia diagnosed in our hospital from January 2012 to October 2014 were scanned by large and small voxel models of 3D-TOF sequence and VIBE sequence， the trifacial nerve peripheral blood vessel number of the patients was recorded， the SNR （signal/noise ratio） and CNR （contrast noise ratio） of the patients were calculated and analyzed. Results The 3D-TOF sequence and VIBE sequence visually presented the vascular trend that was hard to definitely determine in the original image and the relationship between perstriction and symptoms of patients， in the 96 cases of patients， 24 cases were treated with operation， among them， the offending vessel lying in anterior cerebeller artery on the right side was in 12 cases， lying in anterior inferior cerebellar artery was in 9 cases， lying in the bridging vein of anterior cerebeller artery on the right side and anterior inferior cerebellar artery was in 3 cases， perstriction or contact in trifacial nerve was in 90 cases， non-perstriction or contact with the peripheral blood vessel was in 6 cases， and the positive rate was 94%， at the same time， the blood vessel number showed by 3D-TOF sequence scanning was fewer than that showed by VIBE sequence scanning. Conclusion The 3D-TOF sequence and VIBE sequence can overcome the shortcomings of these two sequences， improve the image taking speed of nerve and blood vessel and definitely distinguish the offending vessels of different sizes and blood flow rates， and it is of better clinical significance for the diagnosis of prosopalgia.

[Key words] 3D-TOF sequence； VIBE sequence； Prosopalgia； SNR； CNR

TN是原发性三叉神经痛的简称，是由单条或多条责任血管压迫三叉神经的根部引起的，也是较常见的脑神经痛，其临床症状主要表现为分布区内短暂性反复发作性的刀割样或灼烧样剧痛[1]。三叉神经痛的诊断是根据具有高分辨率的神经及血管结构来显示的。……