MR 血管成像Hosoya 评分对面肌痉挛病因诊断中

血管压迫程度的量化研究
王冰 刘好文 任士卿 张丽霞 孙为民 马晓辉 张敏
【摘要】 目的 对面肌痉挛( hemifacial spasm, HFS) 患者面神经根部血管压迫的程度进行量化
研究, 评价Hosoya 评分在面肌痉挛病因诊断中的价值并对其进行改良。方法 对20 例正常人及
36 例偏侧面肌痉挛患者进行脑干部位三维时间飞跃法MR 血管成像( 3D-TOF MRA) 检查, 采用
Hosoya 评分及改良Hosoya 评分对轴面﹑冠状面原始图像面神经根部的血管压迫进行量化评分, 对改
良Hosoya 评分≥1. 5 分的27 例患者进行血管减压治疗。术后复查MR 血管成像( MRA) , 并重新进
行改良Hosoya 评分。结果 20 例正常人Hosoya 评分, 仅有3 例为1. 0 分, 无一例≥1. 5 分, 判断为无
血管压迫; 36 例HFS 患者中, 患侧Hosoya 评分≥1. 5 分者27 例, 阳性率81. 8% , 按改良Hosoya 评分,
患侧≥1. 5 分者33 例, 阳性率91. 7% ; 有6 例小血管骑跨在面神经根部, Hosoya 评分无法评价, 通过
改良的Hosoya 评分方可确定量化; 患者手术前后改良Hosoya 评分经秩和( 等级分组) 检验, 差异有统
计学意义( H = 27. 192, P < 0. 001) 。结论 Hosoya 评分能对面肌痉挛患者面神经出脑干处的血管压
迫情况进行量化, 但对小血管压迫有一定局限性, 改良Hosoya 评分可以弥补这一缺陷。
【关键词】 半面痉挛; 局部缺血; 损伤严重度评分; 磁共振成像
A quantitative study on t he severity of neur ovascular compression in etiologic diagnosis of hemifacia l
spasm using Hosoya gr ading syst em of MR angiogr aphy WANG Bing, LIU Hao-wen, REN Shi-qing,
ZHANG Li-xia , SUN Wei-min, MA Xiao-hui, ZHANG Min. Department of Neurology, The Third Hospital of
Hebei Medica l College, Shijiazhuang 050051, China
【Abstra ct 】 Object ive To quantitate the severity of neurovascular compression of facial nerve in
patients with hemifacial spasm ( HFS) and evaluate the value of Hosoya grading system in diagnosis of HFS.
Methods Three-dimensional time of flight magnetic resonance angiography ( 3D-TOF MRA) was performed
in 36 patients with HFS and 20 healthy controls , the standard and verified Hosoya grading system were
employed to quantitate the severity of neurovascular compression in axis and coronal plane of head,
21 patients whose verified scores were above 1. 5 undergo vascular decompression. After operation, MRA
and Hosoya grading were reperformed. Results The scores of 20 healthy controls was all less than 1 except
of 3 cases, their scores were 1. The scores were above 1. 5 in 27 of 36 patients using standard Hosoya system
and in 33 of 36 patients using verified system. The positive rates were 81. 8% and 91. 7% , respectively.
Conclusion Hosoya grading system is effective in diagnosis of neurovascular compression in patients with
HFS, but its value in evaluating microvascular compression is limited, and verified Hosoya grading system
can do it well.
【Key wor ds】 Hemifacial spasm; Ischemia; Injury severity score; Magnetic resonance imaging

MR 血管成像Hosoya 评分对面肌痉挛病因诊断中.rar