血管壓迫程度的量化研究
王冰 劉好文 任士卿 張麗霞 孫為民 馬曉輝 張敏
【摘要】 目的 對面肌痙攣( hemifacial spasm, HFS) 患者面神經根部血管壓迫的程度進行量化
研究, 評價Hosoya 評分在面肌痙攣病因診斷中的價值并對其進行改良。方法 對20 例正常人及
36 例偏側面肌痙攣患者進行腦干部位三維時間飛躍法MR 血管成像( 3D-TOF MRA) 檢查, 采用
Hosoya 評分及改良Hosoya 評分對軸面﹑冠狀面原始圖像面神經根部的血管壓迫進行量化評分, 對改
良Hosoya 評分≥1. 5 分的27 例患者進行血管減壓治療。術后復查MR 血管成像( MRA) , 并重新進
行改良Hosoya 評分。結果 20 例正常人Hosoya 評分, 僅有3 例為1. 0 分, 無一例≥1. 5 分, 判斷為無
血管壓迫; 36 例HFS 患者中, 患側Hosoya 評分≥1. 5 分者27 例, 陽性率81. 8% , 按改良Hosoya 評分,
患側≥1. 5 分者33 例, 陽性率91. 7% ; 有6 例小血管騎跨在面神經根部, Hosoya 評分無法評價, 通過
改良的Hosoya 評分方可確定量化; 患者手術前后改良Hosoya 評分經秩和( 等級分組) 檢驗, 差異有統
計學意義( H = 27. 192, P < 0. 001) 。結論 Hosoya 評分能對面肌痙攣患者面神經出腦干處的血管壓
迫情況進行量化, 但對小血管壓迫有一定局限性, 改良Hosoya 評分可以彌補這一缺陷。
【關鍵詞】 半面痙攣; 局部缺血; 損傷嚴重度評分; 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 評分對面肌痙攣病因診斷中.rar