中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (4): 475-478.doi: 10.13418/j.issn.1001-165x.2015.04.023

• 临床研究 • 上一篇    下一篇

3D-FIESTA及MRVE成像技术对Ⅸ、Ⅹ脑神经与神经源性高血压的病因初探

徐建民1 , 黄泽第2 , 黄振林1, 甄云1   

  1. 深圳市宝安区中心医院 1.神经外科,2.放射科,  深圳   518102
  • 收稿日期:2015-01-20 出版日期:2015-07-25 发布日期:2015-08-14
  • 作者简介:徐建民(1968-),男,江苏人,副主任医师,研究方向:脑神经血管外科学,神经外科,Tel:(0755)27693090,E-mail:xjm617@126.com
  • 基金资助:

    深圳市科技计划(医疗卫生类)项目(SZ201003346)

A preliminary study on the relationship between  Ⅸ、Ⅹ cranial nerves and neurogenic hypertension by 3D-FIESTA and MRVE imaging technology

XU Jian-ming1, HUANG Ze-di2, HUANG Zhen-lin1, ZHEN Yun   

  1. 1.Department of Neurosurgery, 2.Department of Radiology, The Central Hospital of Baoan District, Shenzhen, Guangdong 518102,China
  • Received:2015-01-20 Online:2015-07-25 Published:2015-08-14

摘要:

目的 利用MR新技术探讨部分原发性高血压患者延髓的血管与神经解剖比邻的空间关系。  方法 应用高分辨3D-FIESTA及MRVE成像技术对临床拟诊断神经源性高血压患者和正常对照组检查。  结果 脑神经进入脑干区延髓腹外侧血管压迫或接触占59.38%(19例),其中V 2例、Ⅸ和X 17例,未见明显血管压迫及接触的占40.62%(13例)。其中血管与脑干不相交未接触占21.86%(7例);血管与脑干相交未接触例占18.75%(6例);血管与脑干轻微接触占28.13%(9例);血管与脑干接触并压迫脑干移位变形占31.25%(10例)。与神经接触主要是小脑下后动脉与椎动脉,分别占52.6%(10例)与36.8%(7例);小脑下前动脉仅占10.5%(2例)。  结论    MR 3D-FIESTA成像及MRVE后处理技术能显示原发性高血压患者延髓的神经血管关系,对部分原发性高血压明确病因和指导治疗有一定意义。

关键词: 神经源性高血压, 3D-FIESTA, MRVE, 脑神经, 延髓

Abstract:

Objective We investigated the anatomical spatial relations between vessels and nerves around the medulla oblongata in patients with primary medullary hypertension by MR new techniques.  Methods Patients with diagnosis of neurogenic hypertension and patients in the control group underwent high resolution 3D-FIESTA and MRVE imaging. Results The cranial nerves were vascularly compressed and in contact with the vessels on the ventrolateral aspect of medulla oblongata in 19 cases, accounting for 59.38%, including 2 cases of V, 17 cases of IX and X. 13 cases had no obvious vascular compression and contact. The blood vessels and brain stem did not contact or intersect in 7 cases (21.86%); and the brain stem and vessels intersect but not in contact in 6 cases (18.75%); brain stem and vessels contact in a small area(28.13%); and the brain stem and vessels contacted and the brain stems were displaced in 10 cases (31.25%). The vessels that were in contact with the nerves included the posterior inferior cerebellar artery in 10 cases  and the vertebral artery in 6 cases. The anterior inferior cerebellar artery accounted for only 10.5%. Conclusions MR 3D-FIESTA imaging and MRVE post-processing techniques can display the medulla oblongata neurovascular relationships of primary hypertension patients, and has a certain significance for investigation of the etiology of primary hypertension and for treatment guidance.

Key words: Neurogenic hypertension, 3D-FIESTA, MRVE, Cranial nerve, Medulla