MRI reconstruction observation and clinical application of the cisternal segment of facial nerve with its surrounding vessels
MIAO Ying-ying, LV Fang, HOU Ming-yue, ZHAO Jun-qiang, FU Sheng-qi
Chinese Journal of Clinical Anatomy ›› 2018, Vol. 36 ›› Issue (1) : 17-21.
MRI reconstruction observation and clinical application of the cisternal segment of facial nerve with its surrounding vessels
Objective To provide evidence for the morphological diagnosis on the oppression and contact of the cisternal segment of facial nerve with its surrounding vessels. Methods 140 normal and 70 patients with unilateral hemifacial spasm were selected by MRI 3D-FIESTA and 3D-TOF sequence scanning. The following parameters were observed in the MPR reconstruction image, including the vascular diameter, distance to brainstem vascular self angle and included angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels, and its relationship with the morbidity of hemifacial spasm. Results The vascular diameter, distance to brainstem, vascular self angle and included angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels were (0.48±0.03)mm, (0.49±0.04)mm, (0.71±0.06) mm and (8.69±0.62) mm, (8.66±0.75)mm, (5.93±0.47) mm and (74.39±2.33) °, (72.66±2.54) °, (48.57±3.28) ° and (85.60±3.07) °, (86.75±2.73) °, (88.41±3.76) ° on the normal group, uninjured group of hemifacial spasm, ipsilateral group of hemifacial spasm， respectively. There were significant difference between the ipsilateral group of hemifacial spasm to the normal group, uninjured group of hemifacial spasm at the vascular diameter, to brainstem distance and vascular self angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels (P<0.05), there was no significant difference at the included angle(P>0.05). The morbidity decreased with the increase of intersection to brainstem distance, increased with the enlargement of vascular diameter and the reduction of vascular self angle. There was no significant change between the included angle to morbidity. Conclusions The vascular diameter, distance to brainstem and vascular self angle at the intersection of the cisternal segment of facial nerve with its surrounding vessels are important diagnostic markers whether the oppression or contact exists. The lesser of the vascular self angle, the larger of the vascular diameter and the shorter of the distance between the intersection and brainstem, the more prone the patient is to hemifacial spasm lesions.
Facial nerve / Brain vessel / Magnetic resonance imaging / Multiplanar reconstruction / Hemifacial spasm
[1] Auger RG, Whisnant JP. Hemifacial spasm in Rochester and Olmsted County, Minnesota, 1960 to 1984 [J]. Arch Neurol, 1990, 47(11): 1233-1234.
[2] 刘清军, 张云鹤, 朱军, 等. 面肌痉挛微血管减压术中监测异常肌电反应的作用 [J]. 天津医科大学学报, 2010, 16(3): 264-266.
[3] Zhu J, Li ST, Zhong J, et al. Role of arterioles in management of microvascular decompression in patients with hemifacial spasm [J]. J Clin Neurosci, 2012, 19(3): 375-379.
[4] Hatipoglu HG, Durakoglugi1 T, Ciliz D, et a1. Comparison of FSE T2 and 3D-FIESTA sequences in the evaluation of posterior fossa cranial nerves with MR cisternography[J]. Diagn Interv Radiol, 2007, 13(2): 56-60.
[5] Jannetta PJ, Abbasy M, Maroon JC, et al. Etiology and definitive microsurgical treatment of hemifacial spasm: operative techniques and results in 47 patients [J]. J Neurosurg, 1977, 47(3): 321-328.
[6] 郑红伟, 祁佩红, 薛鹏, 等. 3.0T MR 3D-FIESTA +C成像序列结合多平面重建对I-XII对脑神经脑池段的成像研究[J]. 实用放射学杂志, 2012, 28(6): 849-852.
[7] Tomii M, Onoue H, Yasue M, et a1. Microscopic measurement of the facial nerve root exit zone from central glial myelin to peripheral schwann cell myelin [J]. J Neurosurg, 2003, 99(2): 121-124.
[8] 胡辉军, 王东烨, 曾伟科, 等. 小脑下前动脉的64层螺旋CT血管造影评价[J]. 岭南急诊医学杂志, 2015, 20(6): 495-497.
[9] 郭若泪, 李庆玲, 陈少琼, 等. 小脑下后动脉的320排CT血管造影形态学分析[J]. 实用放射学杂志, 2012, 28(9): 1319-1322.
[10] Shimanskii VN, Karnaukhov VV, Sergienko TA, et al. Endoscopic assistance in microvascular decompression of cranial nerves [J]. Zh Vopr Neirokhir Im N N Burdenko, 2012, 76(2): 3-10.
[11] 韩晓红，李晓鹏, 李培, 等. 大脑中动脉M1段的显微解剖与血管造影对照观测及临床意义[J]. 中国临床解剖学杂志, 2013, 31(2): 154-157.
[12] 陈彤，徐涛, 戎伯英, 等. 小脑下后动脉的显微解剖研究[J]. 中国微侵袭神经外科杂志, 2006, 11(6): 267-268.
[13] Ying T, Thirumala P, Chang Y, et al. Emprical factors associated with brainstem auditory evoked potential monitoring during microvascular decompression for hemifacial spasm and its correlation to hearing loss[J]. Acta Neurochir, 2014, 156(3): 571-575.
[14] 胡昊, 吴飞云, 许晓泉, 等. 磁共振3D-SPACE序列对血管压迫性面肌痉挛的诊断价值[J]. 实用放射学杂志, 2014, 30(2): 203-206.
/
| 〈 |
|
〉 |
