cardiotomskСибирский журнал клинической и экспериментальной медициныSiberian Journal of Clinical and Experimental Medicine2713-29272713-265XTSU publishing10.29001/2073-8552-2017-32-4-35-40cardiotomsk-363Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESВЫСОКОПОЛЬНАЯ МАГНИТНО-РЕЗОНАНСНАЯ ТОМОГРАФИЯ В ВИЗУАЛИЗАЦИИ ВАЗОНЕВРАЛЬНОГО КОНФЛИКТА ПРИ ТРИГЕМИНАЛЬНОЙ НЕВРАЛГИИ (НА ТОМОГРАФАХ 1,5 И 3 ТЕСЛА)HIGH-FIELD MAGNETIC RESONANCE IMAGING IN TRIGEMINAL NEURALGIA CAUSED BY NEUROVASCULAR CONFLICT (ON TOMOGRAPHS 1.5 TL AND 3 TL UNITS)РзаевД. А.RzaevJa. A.

канд. мед. наук, врач-нейрохирург, главный врач Федерального центра нейрохирургии Министерства здравоохранения Российской Федерации, доцент кафедры нейронаук Института медицины и психологии Новосибирского государственного университета

Cand. Sci. (Med.), Neurosurgeon, the Head of Federal Neurosurgical Center, Associate Professor of Neurosciences Department, Institute of the Medicine and Psychology, Novosibirsk State University

d_rzaev@neuronsk.ruАмелинМ. Е.AmelinM. E.

канд. мед. наук, рентгенолог, заведующий отделением лучевой диагностики Федерального центра нейрохирургии Министерства здравоохранения Российской Федерации, ассистент кафедры фундаментальной медицины Новосибирского государственного университета

Cand. Sci. (Med.), Radiologist, the Head of Xray Department, Federal Neurosurgical Center, Assistant of the Fundamental Medicine Department, Novosibirsk State University

m_amelin@neuronsk.ruМойсакГ. И.MoisakG. I.

канд. мед. наук, врач-невролог Федерального центра нейрохирургии Министерства здравоохранения Российской Федерации, старший преподаватель кафедры фундаментальной медицины Новосибирского государственного университета

Cand. Sci. (Med.), Neurologist of Federal Neurosurgical Center, the Lecturer of the Neuroscience Department, Institute of Medicine and Psychology, Novosibirsk State University

g_moysak@neuronsk.ruФедеральный центр нейрохирургии Министерства здравоохранения Российской Федерации, НовосибирскРоссияFederal Neurosurgical Center, NovosibirskRussian Federation2017190220183243540Copyright © Рзаев Д.А., Амелин М.Е., Мойсак Г.И., 20182018Рзаев Д.А., Амелин М.Е., Мойсак Г.И.Rzaev J.A., Amelin M.E., Moisak G.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.sibjcem.ru/jour/article/view/363

Высокоразрешающая магнитно-резонансная томография (МРТ) является неотъемлемой частью диагностического процесса для уточнения показаний к операции и планирования тактики оперативного лечения у пациентов с нейроваскулярным конфликтом. Благодаря большей напряженности магнитного поля томографы 3 Тл имеют лучшее соотношение сигнал–шум, улучшающее качество изображения. Цель данного исследования: сопоставление качества визуализации аппаратов 1,5 и 3 Тл при нейроваскулярном конфликте у пациентов с тригеминальной невралгией. Материал и методы. 25 пациентов с нейроваскулярным конфликтом были обследованы на томографах с напряженностью магнитного поля 1,5 и 3 Тл с использованием 3D CISS изображений. При этом сравнивали четкость визуализации и отграничения анатомических структур, качество изображения, полученное на двух аппаратах. При оперативном лечении (микроваскулярная декомпрессия корешка тройничного нерва) проводили сравнение оперативных находок с выявленными на МРТ изменениями. Результаты. Изображения на томографе с напряженностью магнитного поля 3 Тл были более четкими по сравнению с томографом 1,5 Тл по соотношению сигнал-шум, имели лучшее анатомическое разрешение, в большей степени соответствуя интраоперационным находкам, включая более четкую дифференцировку сосудистых структур и нервов, а также мелких сосудистых ветвей. У некоторых пациентов по данным исследования, полученным на томографе 3 Тл, была выявлена более высокая степень компрессии тройничного нерва по сравнению с данными томографа 1,5 Тл. Выводы. Для выявления нейроваскулярного конфликта у пациентов с тригеминальной невралгией желательно проводить исследование на томографах с напряженностью магнитного поля 3 Тл, имеющих большую чувствительность и более высокую точность в определении степени компрессии корешка тройничного нерва и наличия мелких сосудов в зоне компрессии нерва. Наши данные показали, что томографы с напряженностью магнитного поля 1,5 Тл также позволяют выявить основной «причинный» сосуд или их сочетание, которые компримируют корешок тройничного нерва.

 

High-resolution magnetic resonance imaging (MRI) plays an important part in the diagnostic process of clarification of indications for operating and planning operative treatment tactics in patients with neurovascular conflict. Due to higher strength of field 3 Tl MR units have better signal to noise ratio and better image quality. The aim of the study is to compare imaging quality in 3 Tl and 1.5 Tl MR units in patients with neurovascular conflict. Material and Methods. 25 patients with neurovascular conflict were examined in 3 Tl and 1.5 Tl MR units using 3D-CISS images. Delimitation and acuity of anatomical structures, quality of images of two devices were compared. During surgical treatment (microvascular decompression of trigeminal nerve) was made a comparison of MR-images with operation findings. Results. Images in 3 Tl MR unit had better signal to noise ratio and anatomical resolution, in a greater degree corresponding with intraoperational findings, including better differentiation of small vascular and neural structures, and also small vascular branches. According to the research data obtained in tomograph 3 Tl, higher degree of trigeminal nerve compression in comparison with the data of tomograph 1.5 Tl was revealed in some patients. Conclusion. To estimate the neurovascular conflict in patients with trigeminal neuralgia it is better to perform CISS-visualization in 3 Tl MR units having higher sensitivity and delicacy to determine the degree of trigeminal nerve root compression and the presence of small vessels in nerve compression zone. The data have shown that 1.5 Tl MR units also allow us to identify the major causalgic vessel or their combination which compress trigeminal nerve root.

 

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The authors declare that there are no conflicts of interest present.