| BackgroundTrigeminal neuralgia was a kind of common disease, the incidence of 4.1～5.3/10 ten thousand,72%～83% happen in over 40 years old of the elderly, the age group of peaks for 52～76 years old, the women slightly more than men. Magnetic resonance imaging(MRI) was a powerful multi-planar reconstruction(MPR) technique and the reconstruction of the image post-processing function, against the background of cerebrospinal fluid could display the cisternal segment of trigeminal nerve(V) and its surrounding structure, it could beintuitive accurate spatial positioning.ObjectiveUsing MRI image multi-plane reorganization(MPR) post-processing, observations the cisternal segment of trigeminal nerve(V), on the MRI reconstruction image, cross section diameter and cross-sectional area and the length of the trigeminal nerve pons angle, the pons-cerebellum angle, and their relation with the location of the adjacent blood vessels, etc. To provide the anatomical basis for the cause of trigeminal neuralgia diagnosis and microvascular decompression(MVD) treatment, etc.Materials and methodsCollecting images of the Zhumadian city centre hospital, between January 2013 to June 2015, during the implementation of head MRI three-dimensional fast imaging employingsteady state acquisition(3D-FIESTA) scanning imaging sequence of normal images of 100 cases (200 sides) and the image of 50 patients with trigeminal neuralgia. Will be inspectors all the original image data input workstation,3D reconstruction using the multi-plane reorganization(MPR) technology, respectively in oblique cross sectional, oblique sagittal and coronary bits, in 0.50 mm thick layer of image reconstruction. Observated cisternal segment of the trigeminal nerve(V) length, the diameter of cross section, the cross-sectional area and angle of trigeminal nerve pons, the pons-cerebellum angle, and cisternal segment of the trigeminal nerve(V) rather than the location of the adjacent structure relationship, more normal images group and the patients with trigeminal neuralgia group measured value. Using SPSS 13.0 software for statistical data from processing, measurement data using x±x deviation.Results1. On the three-dimensional fast imaging employingsteady state acquisition (3D-FIESTA) sequences imaging, cerebrospinal fluid show high signal, the cisternal segment of trigeminal nerve(V) in low signal, clear contrast between the both. In the restructuring of the multiple-planar reconstruction(MPR) technique images, the cisternal segment of trigeminal nerve(V) at a 100% rate. Left and right, male and female of the cisternal segment of trigeminal nerve(V), there was no significant difference in level or above and a former below forward direction into Meckel cavity ratio was 59.5%(119/200),25.0%(50/200),15.5%(31/200). Trigeminal nerve (V) before entering Meckel cavity, it was 27.5%(55/200) separation, which is a high signal of cerebrospinal fluid. It was 72.5%(145/200) beam, which had high signal of cerebrospinal fluid. The cisternal segment of trigeminal nerve(V) walk down to the bottom of the line in the sensory root, both osteotomies were no separation or separation ratio was 63.5%(127/200),36.5%(73/200).2. The cisternal segment of trigeminal nerve(V) of the length, the maximum diameter, cross section area and angle of trigeminal nerve pons, the pons-cerebellum angle, there were no significant difference on left and right, male and female, it was (7.64±2.16) mm, (3.44±1.56) mm, (24.27±3.82) mm2, (50.43±5.25)°, (233.76±9.50) ° respectively. Cross section of the trail had a significant difference between male and female, it was (2.40±0.36) mm, (2.10±0.46) mm respectively. The cisternal segment of trigeminal nerve(V) on left and right, male and femal with the superior cerebellar artery, the location of the cerebellar arteries relations, there were no significant difference on separation and superior cerebellar artery, contact, oppression of than column were 44.5%(89/200),41.0%(82/200),14.5%(29/200), contact with cerebellar arteries not less than 6 mm and the distance were 73.0%(146/200),73.0% (125/200), cerebellum pancreas-duodenal arteries in the cisternal segment of trigeminal nerve(V) ventrolateral, lateral and ventral ratio was 63.5%(127/200), 18.5%(37/200),18.0%(38/200).3. Trigeminal neuralgia patients suffering from the cisternal segment of trigeminal nerve(V) length, cross-sectional area, and trigeminal nerve pons angle, the pons-cerebellum angle measurements were (5.22±0.73)mm, (17.57±2.02)mm2, (40.70±2.01)°, (216.31±10.56)° respectively, patients were significantly smaller than the contralateral value and normal image, there were significant differences between the both. Lead to the responsibility of the trigeminal neuralgia blood vessels the main were superior cerebellar artery, cerebellar arteries, cerebellum, basal artery and vein rock and their points(genus), etc, the source proportion were 74.0%(37/50),12.0% (6/50),8.0%(4/50),4.0%(2/50),2.0%(1/50). Trigeminal neuralgia patients with visual analogue scale(VAS) rating and vascular compression the cisternal segment of trigeminal nerve(V) between degree of sizing, there was no significant statistical correlation. The clinical symptoms of patients with trigeminal neuralgia, blood vessel diameter, length, angle, there was no significant statistical correlation between clinical symptoms and blood vessel liability spacing between a significant statistical correlation.Conclusion1. MRI three-dimensional fast imaging employingsteady state acquisition (3D-FIESTA) combined with multi-plane restructuring(MPR) technique, could clearly show the cisternal segment of trigeminal nerve(V) and its relation with the location of the peripheral vascular.2. Observation the MRI image of the cisternal segment of trigeminal nerve(V) and its peripheral vascular, for imaging diagnosis of trigeminal neuralgia and plan formulation of microvascular decompression(MVD) and postoperative evaluation of curative effect in the intuitive anatomy basis was provided. |
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