治疗前的DTI标志物:预测经典三角神经疼痛微血管减压的临床结果 - - 一项系统性审查
Giuseppe Pio Cipollina1, Roberta Costanzo2, Benedetta Maria Campisi1
1Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, Postgraduate Residency Program in Neurological Surgery, Neurosurgical Clinic, "Paolo Giaccone", Palermo, Italy.
Neurosurgical review
|November 3, 2024
概括
扩散张力成像 (DTI) 有助于诊断三角神经疼痛 (TN) 和预测手术成功. DTI参数的变化,如分数异构 (FA) 与治疗结果相关,指导更好的患者护理.
科学领域:
- 神经成像是一种神经成像.
- 放射学 放射学是一门学科.
- 神经外科 神经外科
背景情况:
- 三神经疼痛 (TN) 是一种衰弱的慢性疼痛疾病,通常是由三神经的血管压缩引起的.
- 诊断主要是临床的,但先进的成像对于识别原因和神经损伤至关重要.
- 扩散张力成像 (DTI) 提供了潜在的神经成像标记,以了解TN和外科结果.
研究的目的:
- 系统地审查和评估DTI和曲谱学在评估三神经变化的有效性.
- 分析DTI参数,以改善TN患者的治疗计划和预测结果.
主要方法:
- 对比手术前和手术后MRI与DTI序列的研究的系统审查和元分析.
- 包括从PubMed和Scopus数据库中在2010年4月至2024年1月之间发表的研究.
- 对放射性参数的分析,包括与临床结果相关的分数异构性 (FA),异构性量 (QA) 和辐射扩散性 (RD).
主要成果:
- 包括11项与603名患者的研究;363人患有TN,193人经历了微血管减压 (MVD).
- 72.5%的MVD患者显示临床改善; 27.5%没有,可能是由于神经损伤.
- 在受影响的神经中,平均FA从MVD前的0.328增加到MVD后的0.382.
结论:
- 核磁共振-DTI参数 (FA,RD,QA) 对TN诊断和预测治疗成功非常有价值.
- 较低的FA和较高的RD值表明更好的外科手术结果.
- 需要进一步的研究,以将DTI纳入临床决策,以改善患者护理.
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