临床外科杂志 ›› 2020, Vol. 28 ›› Issue (6): 533-536.doi: 10.3969/j.issn.1005-6483.2020.06.010

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术前弥散张力成像定量分析对三叉神经痛病人手术效果的预测价值

  

  1. 辽宁省辽阳市中心医院神经外科
  • 出版日期:2020-06-20 发布日期:2020-06-20

The predictive value of preoperative diffusion tension imaging quantitative analysis in patients with trigeminal neuralgia

  • Online:2020-06-20 Published:2020-06-20

摘要: 目的:分析术前弥散张力成像(DTI)定量分析对三叉神经痛病人手术效果的预测价值。方法:2017年5月~2019年4月我院神经外科行微血管减压术的三叉神经痛病人270例。行前瞻性分析,所有病人术前均行DTI检查,根据术后手术效果分为有效组和无效组。比较两组的平均弥散率(MD)、各向异性分数(FA)、相对各异性(RA)和容积比指数(VR)值。结果:两组病人DTI定量分析结果对比,无效组的MD高于正常组,而FA、RA、VR低于有效组,差异有统计学意义(P<0.05)。多因素Logistic回归分析示:MD和拔牙史是影响三叉神经痛病人手术效果的独立危险因素;FA、RA、VR是影响三叉神经痛病人手术效果的保护因素。ROC曲线显示:DTI定量分析中FA对三叉神经痛病人手术效果的预测价值高于MD、RA和TC,其中FA的最佳截点为≤0.31×10-3mm2/s,此时敏感性为92.68%、特异性为60.29%。结论:三叉神经痛病人术前行DTI定量分析可有效的预测微血管减压术的手术效果。

关键词: 弥散张力成像, 三叉神经痛, 微血管减压术, ROC曲线

Abstract: Objective:To analyze the predictive value of preoperative diffusion tension imaging(DTI)quantitative analysis in patients with trigeminal neuralgia.Methods:270 patients with trigeminal neuralgia who underwent microvascular decompression in neurosurgery department of our hospital from May 2017 to April 2019 were prospectively analyzed.All patients received DTI before surgery,after half a year followup,the patients were divided into effective group and ineffective group according to the operation effect.Mean dispersion rate(MD),anisotropy score(FA),relative anisotropy(RA)and volume ratio index(VR)values were compared between the two groups.Results:Quantitative analysis results of DTI in the two groups were compared,MD in the invalid group was higher than that in the normal group(P<0.05),FA,RA and VR were lower than the effective group(P<0.05).Multivariate Logistic regression analysis showed that:MD and the history of tooth extraction were independent risk factors for surgical outcomes in patients with trigeminal neuralgia;FA,RA and VR are protective factors affecting the surgical outcome of patients with trigeminal neuralgia.ROC curve shows:In the quantitative analysis of DTI,the predictive value of FA on the surgical effect of patients with trigeminal neuralgia was higher than that of MD,RA and TC,the optimal cutoff point of FA is less than 0.31×10-3 mm2/s,at this time,the sensitivity was 92.68% and the specificity was 60.29%.Conclusion:Preoperative DTI quantitative analysis in patients with trigeminal neuralgia can effectively predict the surgical effect of microvascular decompression.

Key words: diffusion tension imaging, trigeminal neuralgia, microvascular decompression, the ROC curve

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