中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2014年
9期
624-627
,共4页
李慧%刘春岭%段志毅%顾志强%王浩然
李慧%劉春嶺%段誌毅%顧誌彊%王浩然
리혜%류춘령%단지의%고지강%왕호연
眩晕%前庭疾病%前庭耳蜗神经%神经卡压综合征%血管疾病%磁共振成像
眩暈%前庭疾病%前庭耳蝸神經%神經卡壓綜閤徵%血管疾病%磁共振成像
현훈%전정질병%전정이와신경%신경잡압종합정%혈관질병%자공진성상
Vertigo%Vestibular diseases%Vestibulocochlear nerve%Nerve compression syndromes%Vascular diseases%Magnetic resonance imaging
目的 分析前庭阵发症神经血管压迫的MRI表现特点,并对血管压迫部位和程度在发病中的影响进行探讨.方法 收集28例前庭阵发症(vestibular paroxysmia,VP)患者,以28例其他眩晕病患者作为对照组,经三维-磁共振血管成像技术扫描,对两组患者前庭蜗神经周围有无神经血管交互压迫(neurovascular cross-compression,NVCC)、NVCC类型、责任血管来源及血管压迫部位至脑干的距离进行回顾性分析.结果 VP组NVCC阳性率(27/28,96.4％)显著高于对照组(13/28,46.4％,x2=17.15,P＜0.01).VP组中最常见NVCC类型为血管襻形式压迫(15/35,42.9％),最常见的责任血管为小脑前下动脉(25/35,71.4％),VP组与对照组NVCC分型、责任血管来源差异均无统计学意义.血管严重压迫前庭蜗神经致其变形和(或)移位在VP组为12.5％ (7/56),对照组为0,差异有统计学意义(P =0.013).NVCC距脑干距离VP组为(8.57 ±5.08) mm,对照组为(8.93±4.64) mm,两组差异无统计学意义,但VP组中单侧NVCC距脑干的距离全部小于15 mm,对照组中为7/10,差异有统计学意义(P=0.033).结论 VP患者NVCC的发生率较高,责任血管多为小脑前下动脉,以血管襻形式压迫前庭蜗神经多见,NVCC多发生在前庭蜗神经的中枢髓鞘部;血管压迫部位及程度与VP发病可能相关.
目的 分析前庭陣髮癥神經血管壓迫的MRI錶現特點,併對血管壓迫部位和程度在髮病中的影響進行探討.方法 收集28例前庭陣髮癥(vestibular paroxysmia,VP)患者,以28例其他眩暈病患者作為對照組,經三維-磁共振血管成像技術掃描,對兩組患者前庭蝸神經週圍有無神經血管交互壓迫(neurovascular cross-compression,NVCC)、NVCC類型、責任血管來源及血管壓迫部位至腦榦的距離進行迴顧性分析.結果 VP組NVCC暘性率(27/28,96.4％)顯著高于對照組(13/28,46.4％,x2=17.15,P＜0.01).VP組中最常見NVCC類型為血管襻形式壓迫(15/35,42.9％),最常見的責任血管為小腦前下動脈(25/35,71.4％),VP組與對照組NVCC分型、責任血管來源差異均無統計學意義.血管嚴重壓迫前庭蝸神經緻其變形和(或)移位在VP組為12.5％ (7/56),對照組為0,差異有統計學意義(P =0.013).NVCC距腦榦距離VP組為(8.57 ±5.08) mm,對照組為(8.93±4.64) mm,兩組差異無統計學意義,但VP組中單側NVCC距腦榦的距離全部小于15 mm,對照組中為7/10,差異有統計學意義(P=0.033).結論 VP患者NVCC的髮生率較高,責任血管多為小腦前下動脈,以血管襻形式壓迫前庭蝸神經多見,NVCC多髮生在前庭蝸神經的中樞髓鞘部;血管壓迫部位及程度與VP髮病可能相關.
목적 분석전정진발증신경혈관압박적MRI표현특점,병대혈관압박부위화정도재발병중적영향진행탐토.방법 수집28례전정진발증(vestibular paroxysmia,VP)환자,이28례기타현훈병환자작위대조조,경삼유-자공진혈관성상기술소묘,대량조환자전정와신경주위유무신경혈관교호압박(neurovascular cross-compression,NVCC)、NVCC류형、책임혈관래원급혈관압박부위지뇌간적거리진행회고성분석.결과 VP조NVCC양성솔(27/28,96.4％)현저고우대조조(13/28,46.4％,x2=17.15,P＜0.01).VP조중최상견NVCC류형위혈관반형식압박(15/35,42.9％),최상견적책임혈관위소뇌전하동맥(25/35,71.4％),VP조여대조조NVCC분형、책임혈관래원차이균무통계학의의.혈관엄중압박전정와신경치기변형화(혹)이위재VP조위12.5％ (7/56),대조조위0,차이유통계학의의(P =0.013).NVCC거뇌간거리VP조위(8.57 ±5.08) mm,대조조위(8.93±4.64) mm,량조차이무통계학의의,단VP조중단측NVCC거뇌간적거리전부소우15 mm,대조조중위7/10,차이유통계학의의(P=0.033).결론 VP환자NVCC적발생솔교고,책임혈관다위소뇌전하동맥,이혈관반형식압박전정와신경다견,NVCC다발생재전정와신경적중추수초부;혈관압박부위급정도여VP발병가능상관.
Objective To analyze the MRI characteristics of vestibulocochlea neurovascular compression in patients with vestibular paroxysmia (VP) and to investigate the effect of the compression,its site and degree,on the occurrence of VP.Methods Twenty-eight cases of VP (VP group) and 28 cases of vertiginous patients other than VP (control group) were retrospectively reviewed.Three dimensional magnetic resonance angiography (3D-MRA) was performed and the data were used for neurovascular crosscompression (NVCC) analysis.The frequency and type of NVCC,the origin of the offending vessel and the distance between compression site and brainstem were compared between the two groups.Results The frequency of NVCC was 96.4％ (27/28) in VP group,with a significant difference compared with control group (13/28,46.4％ ;x2 =17.15,P ＜0.01).The most common NVCC type was vascular loop compression at vestibulocochlear nerve (15/35,42.9％).Anterior inferior cerebellar artery was the most common offending vessel (25/35,71.4％) in VP group.There were no significant differences between the two groups in the type of NVCC or the origin of the offending vessel.The frequency on the distortion and (or) displacement of vestibulocochlear nerve which was severely compressed by vessel in VP group (7/56,12.5％) was significantly higher than that in control group (0; P =0.013).The distance between compression site and brainstem was (8.57 ± 5.08) mm in VP group,and (8.93 ± 4.64) mm in control group,showing no significant difference.The ratio that the distance was less than 15 mm between compression site and brainstem in unilateral NVCC of VP group (100％) was significantly higher than unilateral NVCC of control group (7/10,P =0.033).Conclusions The VP patients have higher NVCC incidence and the most common NVCC type is vascular loop compression at vestibulocochlear nerve which is mainly caused by anterior inferior cerebellar artery.NVCC in VP patients mostly occurs in the central myelin portion of vestibulocochlear nerve.The site and degree of neurovascular compression may relate to the occurrence of VP.
