面听神经成像与MRA融合在面听神经相关疾病诊断中的价值研究

The Value of Fusion of Facial Auditory Nerve Imaging and MRA in the Diagnosis of Facial Auditory Nerve Related Diseases

摘要: 探讨磁共振面听神经高分辨率成像(以3D SPACE序列为代表)与磁共振血管成像(MRA)融合技术在面听神经相关疾病诊断中的应用价值，明确其在显示神经与血管解剖关系、提高血管压迫性病变检出率、辅助定位病变及指导临床治疗等方面的作用，为面听神经疾病的精准诊断提供依据。方法：选取86例面听神经相关疾病患者，均行3D SPACE序列及3D TOF-MRA检查，将图像融合后通过多平面重组等方式分析神经与血管解剖关系，由2名医师双盲阅片。结果：96.1%的融合图像可清晰显示面听神经全程及周围血管；特发性面神经麻痹患者中，融合技术对血管压迫的检出率(43.9%)显著高于单纯面听神经成像(26.0%)；听神经瘤患者中，融合图像可明确肿瘤与血管的毗邻关系；血管压迫性三叉神经痛合并面听神经症状患者中，均能清晰地显示责任血管的压迫部位及程度。结论：磁共振面听神经高分辨率成像与MRA融合技术可精准显示面听神经与周围血管的解剖关系，显著提高血管压迫性面听神经病变的检出率，能清晰地区分肿瘤与血管的关系，为面听神经相关疾病的病因诊断、病变定位及临床治疗方案制定提供可靠依据，具有重要临床应用价值。

Abstract: This study explores the application value of the fusion technology of high-resolution magnetic resonance imaging (MRI) of the facial and auditory nerves (represented by the 3D SPACE sequence) and magnetic resonance angiography (MRA) in the diagnosis of facial and auditory nerve-related diseases. It clarifies its role in displaying the anatomical relationship between nerves and blood vessels, improving the detection rate of vascular compression lesions, assisting in lesion localization, and guiding clinical treatment, thereby providing a basis for the accurate diagnosis of facial and auditory nerve diseases. Methods: A total of 86 patients with facial and auditory nerve-related diseases were selected, all of whom underwent 3D SPACE sequence and 3D TOF-MRA examinations. After image fusion, the anatomical relationship between nerves and blood vessels was analyzed through multi-planar reconstruction and other methods, and the images were reviewed double-blind by two physicians. Results: 96.1% of the fused images could clearly display the entire course of the facial and auditory nerves and surrounding blood vessels; in patients with idiopathic facial paralysis, the detection rate of vascular compression by fusion technology (43.9%) was significantly higher than that of simple facial and auditory nerve imaging (26.0%); in patients with acoustic neuroma, the fused images could clarify the adjacent relationship between the tumor and blood vessels; in patients with vascular compressive trigeminal neuralgia combined with facial and auditory nerve symptoms, the location and degree of compression of the responsible blood vessel could be clearly displayed. Conclusion: The fusion technology of high-resolution MRI of the facial and auditory nerves and MRA can accurately display the anatomical relationship between the facial and auditory nerves and surrounding blood vessels, significantly improve the detection rate of vascular compressive facial and auditory nerve lesions, and clearly distinguish the relationship between tumors and blood vessels. It provides a reliable basis for the etiological diagnosis, lesion localization, and formulation of clinical treatment plans for facial and auditory nerve-related diseases, and has important clinical application value.