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| 題 名 | MDCT三度空間導引定位術於三叉神經節阻斷之應用=The Application of Multi-detector CT Guided in Trigeminal Nerve Block |
|---|---|
| 作 者 | 許瓊如; 林秋湧; 廖漢弘; 陳文昌; 吳萬福; | 書刊名 | 中華放射線技術學雜誌 |
| 卷 期 | 36:1 2012.03[民101.03] |
| 頁 次 | 頁33-38 |
| 分類號 | 416.14 |
| 關鍵詞 | 三叉神經痛; 卵圓孔; 多排偵測器電腦斷層; Trigeminal neuralgia; Foramen ovale; Multi-detector CT; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 本研究利用多排偵測器電腦斷層(multi-detector computed tomography; MDCT)並配合3D影像的重組,進行三叉神經阻斷之卵圓孔穿刺導引,以增進定位之準確性,改善以往因為顱底複雜構造在2D透視影像上重疊而導致穿刺定位不易,達到疼痛阻斷之治療效果。病患於MDCT掃描後,求得三度空間穿刺卵圓孔最佳入針點及角度,於麻醉後,由醫師以RF穿刺針沿畫定之入針點與角度往卵圓孔方向穿刺,再進行MDCT掃描確認位置,將原始影像(original data)傳入影像處理工作站(Workstation),來進行3D影像重組,直至穿刺針正確穿刺達卵圓孔。研究期間共有8 名接受三叉神經痛治療。病患都在MDCT三度空間下完成導引定位,並進行神經燒灼。手術成功後,病患疼痛立即解除,但是會有持續性輕度到中度半側顏面麻痺,合併咀嚼肌力減弱情況,但此情形大部分患者三個月後皆能獲得改善。利用MDCT三度空間導引定位,可以將RF穿刺針引導至卵圓孔,治療三叉神經痛;此技術增進定位之準確性,減少開顱手術,可給予患者另一種治療的選擇。 |
| 英文摘要 | Traditionally, trigeminal nerve block via foramen ovale puncture is often achieved with fluoroscopic guidance. To improve puncture rate, the procedure is performed utilizing multi-detector computed tomography (MDCT) and 3D image reconstruction. Patient after the CT scanning, we can obtained the best point and angle to puncture the foramen ovale. After general anesthesia, a physician use a RF needle to puncture the foramen ovale along the drawn direction , then MDCT scan confirmed the location. CT images then were obtained and the original raw data were reconstructed in image workstation to address the exact needle location in 3 dimensions. The needle then advanced stepwise with the aid of reconstructed CT image to reach foramen ovale. 8 cases receiving MDCT guided trigeminal nerve block had instant pain relief. Side effects included mild to moderate ipsilateral facial palsy and decreased masticator muscle power. These side effects improved after 3 month follow up. MDCT guided trigeminal nerve block could effectively and accurately treat trigeminal neuralgia. It provided an alternative option if surgical approach is undesirable or not feasible. |
本系統中英文摘要資訊取自各篇刊載內容。