使用磁共振断层血管造影术对神经血管压迫进行术前评估：我们进行微血管减压术治疗三叉神经痛的放射学指征。
Preoperative evaluation of the neurovascular compression using magnetic resonance tomographic angiography: our radiologic indications for microvascular decompression to treat trigeminal neuralgia.
作者信息
Chen Min-Jie, Zhang Wei-Jie, Guo Zhi-Lin, Yang Chi, Zhang Wen-Hao, Dong Min-Jun, Chai Ying, Zhang Zhi-yuan
机构信息
From the Departments of *Oral and Maxillofacial Surgery, †Neurosurgery, and ‡Radiology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, P.R. China.
出版信息
J Craniofac Surg. 2014 Jul;25(4):e384-8. doi: 10.1097/SCS.0000000000000969.
PURPOSE
The aim of this study was to introduce our classification of the neurovascular compression (NVC) in trigeminal neuralgia and the radiologic indications for microvascular decompression (MVD) based on magnetic resonance tomographic angiography.
METHODS
From 2003 to 2011, 322 patients with primary trigeminal neuralgia were treated with MVD. The score of NVC was from 0 to 3. Three scores, separately from axial, oblique sagittal, and coronal images, were added together. The degree of NVC was classified as follows: grade 0 (0-1), grade 1 (2-3), grade 2 (4-6), and grade 3 (7-9).
RESULTS
In summary, 88.3% (182/206) patients with absolute indication, 78.3% (65/83) patients with relative indication, and 90.9% (30/33) without indication showed excellent results. Among the 27 patients with good result, 13 patients (48.1%) were in grade 1, and 3 (11.1%) were in grade 0. Among the 18 patients with poor result, 5 patients (27.8%) were in grade 1 preoperatively. Five patients with severe complications were all in grade 0 with vague NVC.
CONCLUSION
The patients with grades 2 and 3 (absolute indications) NVC were recommended with MVD.
目的
本研究旨在介绍我们对三叉神经痛中神经血管压迫（NVC）的分类以及基于磁共振断层血管造影的微血管减压术（MVD）的放射学指征。
方法
2003年至2011年，322例原发性三叉神经痛患者接受了MVD治疗。NVC评分为0至3分。分别从轴向、斜矢状面和冠状面图像获得的三个分数相加。NVC程度分类如下：0级（0 - 1分），1级（2 - 3分），2级（4 - 6分），3级（7 - 9分）。
结果
总体而言，有绝对指征的患者中88.3%（182/206）、有相对指征的患者中78.3%（65/83）以及无指征的患者中90.9%（30/33）显示出良好效果。在27例效果良好的患者中，13例（48.1%）为1级，3例（11.1%）为0级。在18例效果不佳的患者中，5例（27.8%）术前为1级。5例严重并发症患者均为0级，NVC不明确。
结论
推荐对NVC为2级和3级（绝对指征）的患者进行MVD。
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