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华西医学  2010 

三叉神经痛伽玛刀治疗前MRI扫描序列研究

, PP. 1495-1498

Keywords: 伽玛刀,三叉神经痛,磁共振成像,放射治疗,定位

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Abstract:

【】目的探讨伽玛刀治疗三叉神经痛MRI定位的最佳扫描序列。方法选择2004年7月-2006年3月行伽玛刀手术的原发性三叉神经痛患者60例,随机分为3组,每组各20例。伽玛刀术前上头架定位,然后对3组分别采用快速自旋回波序列(TurboSpinEcho,TSE)、增强三维小角度激发快速梯度回波序列(enhancedthree-dimensiunalfastlowangleshot,enhanced3D-FLASH)、三维结构干涉稳态序列(three-dimensionalconstructiveinterferenceinsteadystate,3D-CISS)进行扫描,观察三叉神经及周围血管的显示情况。结果①TSE扫描20例三叉神经,14例显示优,血管显示一般。②增强3D-FLASH扫描三叉神经,18例显示优,2例显示良,周围血管显示优。③3D-CISS扫描三叉神经,20例均显示优,周围血管显示良。结论3D-CISS和增强3D-FLASH序列的融合影像能够清晰地显示三叉神经根及周围血管,有利于伽玛刀的精确定位,具有较高的临床应用价值,可以作为伽玛刀治疗原发性三叉神经痛的常规定位方法。?【Abstract】ObjectiveToevaluatetheoptimalMRIlocalizationsequencesofgammakniferadiosurgeryfortrigeminalneuralgia.MethodsFromJuly2004toMarch2006,sixtypatientswithprimarytrigeminalneuralgiaweredividedintothreegroups,usingMRTurboSpinEcho(TSE),enhancedthree-dimensiunalfastlowangleshot3D-FLASHandthree-dimensionalconstructiveinterferenceinsteadystate(3D-CISS)sequenceforstereotacticlocalization,respectively.Thetrigeminalnerveandsurroundingvesselswereobserved.ResultsOnly14trigeminalnerveswerepreciselydisplayedbyMRTSEsequence,while20by3D-CISSand18by3D-FLASH.Thedisplayofsurroundingvesselswasexcellent,good,andgeneralby3D-FLASH,3D-CISS,andMRTSE,respectively.Conclusion3D-CISSandenhanced3D-FLASHfusionimagecanhelpachieveaccurateorientationofgammaknife,whichprovidesclearimagesofthetrigeminalnerveandthesurroundingvessels.Thereforeitisofhighvalueinclinicalapplication,whichcanbeusedastheconventionallocalizationmethodforgammakniferadiosurgeryinthetreatmentofprimarytrigeminalneuralgia.

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