The Value Of3D-TOF And3D-FIESTA Sequence In The Study Of The Relationship Around The Trigeminal Neuralgia

Objective：To investigate the nuclear magnetic resonance3D-TOF and3D-FIESTAsequence and aplication value in the relationship between trigeminal nerve andadjacent structures around the study of, including two parts: the first part is MRI3D-TOF combined with3D-FIESTA sequence in primary trigeminal neuralgia(Trigeminal neuralgia, TN) diagnostic value in the implementation, whethermicrovascular decompression (MVD), has realistic guiding significance forartery, vein of contact or opression and the presence of arteriovenous running,sources; second part is MRI3D-TOF and3D-FIESTA sequences are combinedin the normal population in the study the relationship between trigeminal nerveand vessels, provides data the basic research for the further study of primarytrigeminal neuralgia, provide the basis for diagnosis and better information forclinical diagnosis of idiopathic trigeminal neuralgia.Materials and Methods：1. The research object to choose(Part1) collected in September2012-September2013Shandong provincialhospital clinical diagnosis of patients with trigeminal nerve during30people,12cases were male, female18cases, course of3months to8years, the average (3+/-5.6) years, age36~62, the average age (46.3+3.9); Both match the patientsage, sex, the control group30cases,14cases of male, female16cases,28~58years old,(40.6-3.8) years old;(Part2) to choose10to60,150health,according to the age of10~20,21~30,31~40,41~50,51~60years old group,divided into5groups, each group of30people, male, the female15each. Allthe subjects are conventional MRI, except other intracranial primary and secondary pathological changes, magnetic resonance (NMR)3D-TOF/3D-FIESTA sequence scan, scan each position of the original image reconstruction,to the best orientation nervous relationship with surrounding structures, judgewhether responsibility vascular compression of trigeminal nerve.2. Aparatus and equipmentUsing3.0T GE (Signa HD GEMSGEMS) x type superconducting MRIscanner (American General Electric Company), the phase front circle head8channel, test subjects were first regular head MRI, including axial scanningsequence T2WI, T1WI, T2W-FLAIR sequence, sagittal, coronal T2WI sequenceT2WI sequences,3D-TOF and3D-FIESTA sequence, the scanning parametersare as follows: SE T1WI-(TR1949ms TE26ms), FSE T2WI (TR3280ms and110ms) TE image layer thickness3mm;3D-TOF and3D-FIESTA sequence scanparameters: TR17.0ms and5.7ms, TE flip Angle:70degrees, a single signalacquisition, do not add to saturation pulse, layer number of50,1.0mm, with athick layer of FOV175mm*230mm; All finish scanning sequence in GEprovide ADW4.5workstations, each position using Reformat software forreconstruction, in order to best position shows that the relationship betweennerves and blood vessels. Uper brain stroke include bridge to bridge gapbetween organizational structure, which includes the level of the trigeminalnerve and facial nerve.3. Image analysisTwo high qualification MRI image doctor firstly look at the conventionalMRI images, with exception of intracranial primary and secondary pathologicalchanges, and then observe the client to scan3D-TOF and3D-FIESTA raw datafrom the whole understanding of trigeminal nerve and observe the relationshipbetween nerves and blood vessels, and finally the multi-plane reorganizationtechnology from the different Angle and level observation trigeminal nerve withand without vascular compression and compression degree and direction andfind the source of blood vessels.(1) the relation between opression or morelevels show that nerve and the connection between adjacent blood vessels,including at least one bearing showing nerve vascular contact parts have nervecompression or deformation;(2) the contact relationships or more levels showthat nerve and connection between adjacent blood vessels;(3) the questionablecontact relations: only can display on a level with nerve vascular contact performance;(4) no contact relationship: all levels have shown no contactbetween nerve and adjacent blood vesselsResults30patients in4cases were caused by the cerebellopontine Angle areatumor (1case of trigeminal schwannoma is shown in figure1,1cases ofacoustic neuroma,1case of cholesteatoma,1case of meningioma,1case wasconfirmed by surgery for arachnoid adhesion, arachnoiditis, arachnoid stripingremission of symptoms of trigeminal neuralgia,3cases not found the cause,more than22cases of primary trigeminal neuralgia,19cases symptoms sideresponsibility with the first Ⅴ vascular compression nerve, positive rate was86.4%, and is consistent with the operation control structure; Normal controlgroup30cases of healthy volunteers,8cases of positive, ratio of about26.7%.Vessels in19patients with trigeminal nerve pons period see (figure2) andconfirmed by surgery (figure3), the compression of the trigeminal nerve bloodvessels are superior cerebellar artery (10cases), anterior artery (3cases),cerebellar artery (2cases), after high twisted vertebral artery and some smallerbranch blood vessels (2cases), transverse veins and bridge vein (2cases), oneof the most common is superior cerebellar artery. Consistent with domesticliterature reports, the vascular decompression surgery, the symptoms disapear orget a degree. The second part of the results shows: in the normal rate of10-20,the opression of men and women in the crowd were0.067,0.200; Rate of20to30years old the opression of men and women were0.200,0.267;30to40yearsold men and women of the compression ratio of0.267,0.333;40-50,compression ratio of0.467,0.533;50to60years old of compression ratio of0.467,0.6000; Thus it can be seen after age40increased probability oftrigeminal nerve compression,10to40, men’s and women’s opression raterespectively0.178,0.267;40-60years of age is0.467,0.567; Thus it can beseen in the general population of the trigeminal nerve compression ratioincreases with age, particularly after age40, p <0.05statistically significant, thewomen of the trigeminal nerve compression rate is about2times as much as men,so the number of women suffering from trigeminal neuralgia is male, p <0.05statistically significant (table1).ConclusionCerebellopontine Angle area structure is relatively complex, full bridge cerebellum, CPA pool cerebrospinal fluid volume with all can cause the first Ⅴnerve more free space is relatively small, causing pain, but the study found no,asymptomatic side are visible vessels contact or corresponding nervecompression, and even this phenomenon was observed in the child’s brain scan.Peker etc. Think: arteriovenous access or opression signs is not entirely as afirst Ⅴ on the causes of brain nerve pain and reliable, but Satoh, etc. Andespecially to wait using fmri and neural fusion pool imaging of the brain MRIfindings: health side first Ⅴ nerve compression and the degree of contact withthe lateral performance of the lighter, this topic research the result is consistentwith this view, thus alleviate the degree of corresponding cranial nervecompression is the key to relieve the pain.3D-TOF and3D-FIETA combinedsequence can display the trigeminal nerve and adjacent structure and therelationship of the vessels, to find the origin of the corresponding painarteriovenous vessels and contorts the very important, has the important realityguiding sense, MRI of painless, no radiation, multiple important imagingmethod to determine whether craniocerebral surgery to alleviate symptoms andsurgeon how to design the surgery path is important, as well as the probabilityincreases as the growth of the age of the trigeminal nerve compression, and themost significant growth after age40, p <0.05, statistically significant, theprobability of male pressure is lower than female, p<0.05, with statisticalsignificance.