摘要
目的:评估三维可变反转角快速自旋回波(3D sampling perfection with application optimized contrasts using different flip angle evolution,3D-SPACE)序列及微小表面线圈联合三维双回波稳态水激发(3D double-echo steady state with water excitation,3D-DESSwe)序列在听神经瘤手术中保护面神经的作用。方法:回顾性分析病理学检查证实的33例行常规磁共振成像(magnetic resonance imaging,MRI)扫描、3D-SPACE序列扫描及微小表面线圈联合3D-DESSwe序列扫描的听神经瘤患者的MRI资料,并与手术所见和病理学检查结果对照分析,观察、评价3D-SPACE序列及微小表面线圈联合3D-DESSwe序列对听神经瘤患者患侧面神经的显示情况。结果:3D-SPACE序列对周围神经脑池段显示良好,微小表面线圈联合3D-DESSwe序列对听神经瘤内听道段的面神经、后组颅神经显示较清晰。结论:同时应用3D-SPACE序列、微小表面线圈联合3D-DESSwe序列能提高听神经瘤周围神经术前评估的准确性,对保护面神经、保留面神经功能具有重要意义。
Objective: To evaluate the roles of 3 D sampling perfection with application optimized contrasts using different flip angle evolution(3 D-SPACE) sequence and microsurface coil combined with 3 D double-echo steady state with water excitation(3 D-DESSwe) sequence in the protection of facial nerves in acoustic neuroma surgery. Methods: The magnetic resonance imaging(MRI) data of 33 acoustic neuroma patients confirmed by pathology were retrospectively analyzed. The imagings of conventional MRI scan, 3 D-SPACE sequence scan and 3 D-DESSwe sequence combined with microsurface coil scan were compared with surgical findings and pathological results. The display of ipsilateral facial nerves in acoustic neuroma was investigated. Results: 3 D-SPACE could better display the cerebral cisterns of the peri pheral nerves. 3 D-DESSwe sequence combined with microsurface coil could better display the facial nerves in the internal auditory canal and the posterior cranial nerves. Conclusion: 3 D-SPACE sequence and 3 D-DESSwe sequence combined with microsurface coil can improve the accuracy of preoperative evaluation of peripheral nerves of acoustic neuroma, and have important significance in the protection of facial nerves and preservation of facial nerve functions.
引文
[1]王忠诚.神经外科学[M].武汉:湖北科学技术出版社,2005:674-706.
[2]孔祥泉,韩萍,徐海波.高场磁共振周围神经、血管与水成像[M].北京:人民卫生出版社,2013:35-45.
[3]AL-NOURY K,LOTFY A.Normal and pathological findings for the facial nerve on magnetic resonance imaging[J].Clin Radiol,2011,66(8):701-707.
[4]ERDOGAN N,ALTAY C,AKAY E,et al.MRI assessment of internal acoustic canal variations using 3D-FIESTA sequences[J].Eur Arch Otorhinolaryngol,2013,270(2):469-475.
[5]CHU J,ZHOU Z,HONG G,et al.High-resolution MRI of the intra parotid facial nerve based on a microsurface coil and a3D reversed fast imaging with steady-state precession DWIsequence at 3T[J].AJNR Am J Neuroradiol,2013,34(8):1643-1648.
[6]李春星,符益纲,周笑,等.磁共振序列在颅神经血管成像中的应用价值[J].磁共振成像,2016,7(3):180-184.
[7]杜春华,吴飞云,祝因苏,等.磁共振3D-SPACE序列与3D-CISS序列对Ⅴ-Ⅷ颅神经成像的对照性研究[J].临床放射学杂志,2012,31(12):1699-1702.
[8]王晓磊.3D-SPACE序列扫描耳聋患儿内听道病变早期检测效果分析[J].中国现代医学杂志,2017,27(22):121-123.
[9]庄启湘,孙岩,刘可夫,等.MR 3D-SPACE与3D-TOF序列在颅内神经血管压迫综合征的比较研究[J].实用放射学杂志,2017,33(1):20-23.
[10]邓明,王良,李亮,等.3.0T磁共振3D-DESS与3D-SPACE对腰骶神经成像的临床应用价值比较[J].磁共振成像,2015,6(10):750-756.
[11]洪桂洵,初建平,周宙,等.采用小线圈和三维稳态自由进动快速成像脂肪抑制序列显示腮腺段面神经及腮腺导管的价值[J].中华放射学杂志,2015,49(9):641-645.
[12]ZHANG Y,MAO Z,WEI P,et al.Preoperative prediction of the location and shape of the facial nerve in patients with large vestibular schwannomas using diffusion tensor imaging-based fiber tracking[J].World Neurosurg,2017,99:70-78.
[13]BORKAR S A,GARG A,MANKOTIA D S,et al.Prediction of facial nerve position in large vestibular schwannomas using diffusion tensor imaging tractography and its intraoperative correlation[J].Neurol India,2016,64(5):965-970.
[14]何兴,惠旭辉,刘文科,等.弥散张量面神经成像技术在术前预测听神经瘤与面神经关系应用的研究进展[J].医学综述杂志,2017,23(12):2429-2432,2437.
[15]于福超,苏少波,马俊,等.基于弥散张量成像重建听神经瘤患者面神经的研究[J].中华神经外科杂志,2017,33(5):475-478.
