脑桥三叉神经T2高信号能否提示三叉神经痛的疱疹病因？
Can pontine trigeminal T2-hyperintensity suggest herpetic etiology of trigeminal neuralgia?
作者信息
D'Amico Alessandra, Russo Carmela, Ugga Lorenzo, Mazio Federica, Capone Elisa, D'Arco Felice, Mankad Kshitij, Caranci Ferdinando, Marano Enrico, Brunetti Arturo
机构信息
Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
Department of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
出版信息
Quant Imaging Med Surg. 2016 Oct;6(5):490-495. doi: 10.21037/qims.2016.01.07.
BACKGROUND
Trigeminal neuralgia (TN) is usually classified into two different categories: idiopathic and secondary. We have investigated the frequency of brainstem pontine lesions in patients with idiopathic TN without multiple sclerosis (MS) or stroke, and their association with herpes zoster (HZ) infection.
METHODS
Brain magnetic resonance imaging (MRI) studies of 28 patients with TN were retrospectively reviewed.
RESULTS
We found seven patients with clinical suspicion of HZ infection and pontine T2 hyperintense lesions, associated with nerve atrophy in one case. Fifteen patients had a neurovascular conflict (NVC) without brainstem involvement, two of them associated with trigeminal atrophy, while four patients had only volumetric reduction of the nerve. In all patients MRI findings were ipsilateral to the side of TN.
CONCLUSIONS
Pontine T2 hyperintensities could be considered as a MRI sign of TN in patients without NVCs. This "trigeminal pontine sign" (TPS) is frequently found in association with herpetic infections.
背景
三叉神经痛（TN）通常分为两种不同类型：特发性和继发性。我们研究了无多发性硬化（MS）或中风的特发性TN患者脑干桥脑病变的发生率及其与带状疱疹（HZ）感染的关系。
方法
回顾性分析28例TN患者的脑磁共振成像（MRI）研究。
结果
我们发现7例临床怀疑HZ感染且桥脑T2高信号病变的患者，其中1例伴有神经萎缩。15例患者存在神经血管冲突（NVC）但无脑干受累，其中2例伴有三叉神经萎缩，而4例患者仅神经体积减小。所有患者的MRI表现均与TN同侧。
结论
在无NVC的患者中，桥脑T2高信号可被视为TN的MRI征象。这种“三叉神经桥脑征”（TPS）常与疱疹感染相关。
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