BACKGROUND:Patients with self-limited epilepsy with centrotemporal spikes (SeLECTS) and electrical status epilepticus in sleep (ESES) lead to cognitive impairment. However, therapeutic options are limited. OBJECTIVES:The sleep spindle is a biomarker of cognitive dysfunction in patients with SeLECTS. This study aimed to explore whether the sleep spindle is linked to the outcome of repetitive transcranial magnetic stimulation (rTMS) in patients with SeLECTS with ESES. METHODS:Nine patients with SeLECTS with ESES underwent low-frequency rTMS (≤ 1 Hz) or continuous theta burst stimulation (cTBS) for 10 days. To assess the clinical efficacy and alteration in the sleep spindle, EEG recordings were performed both before and after rTMS. A machine learning algorithm YASA was used to calculate the coupling of the sleep spindle and slow waves. RESULTS:75% of patients remained seizure-free for 6 months after rTMS. The spike-wave index (SWI) decreased significantly after rTMS compared with the baseline. The sleep spindle significantly increased in all patients at 3 months and 6 months after rTMS (p = 0.002). Both IQ and MQ improved significantly at 6 months after rTMS. Improvement of IQ and increase of the sleep spindle was significantly positively correlated (p = 0.035). The mean probability of the sleep spindle coupling in the slow wave "up" state increased from 28% to 55%. CONCLUSION(S):Increase of the sleep spindle and the mean probability of the sleep spindle coupling in the slow wave "up" state might be a potential mechanism for cognition improvement in patients with SeLECTS with ESES.

Non-invasive preoperative assessment of tumor grade serves an important role for clinical management. The aim of the present study was to assess the value of an intratumoral and an peritumoral radiomic model in predicting the histological grade of endometrial cancer (EC). A total of 107 patients with EC were retrospectively enrolled and randomly divided into the training (n=74) and test cohorts (n=33). Radiomic features were extracted from intratumoral and peritumoral regions (RT) with different expansion regions (1, 2 and 3 mm) using T2-weighted and the 5 to 8th phase of contrast-enhancement images. The diagnostic performance of several peritumoral features was compared with the maximum area under the curve (AUC) value. These intratumoral features were combined with peritumoral features to construct a fusion model. The AUCs for the RT model were 0.879 [95% confidence interval (CI), 0.797-0.962] for the training cohort and 0.869 (95% CI, 0.590-1.000) for the test cohort. The peritumoral model with a 3-mm expansion (RT-3) demonstrated superior performance, yielding AUCs of 0.934 (95% CI, 0.875-0.994) in the training cohort and 0.875 (95% CI, 0.744-1.000) in the test cohort. The fusion model incorporating features from both RT and RT-3 achieved the highest diagnostic performance for distinguishing low-grade from high-grade EC, with AUCs of 0.955 (95% CI, 0.910-1.000) and 0.885 (95% CI, 0.771-1.000) in the training and test cohorts, respectively. In conclusion, the results of the present study indicate that radiomic features from magnetic resonance images incorporating both intratumoral and peritumoral regions can effectively predict low-and high-grade EC.

To investigate the effectiveness and safety of separation surgery for Epidural Spinal Cord Compression (ESCC) graded ≥ 2 in patients with Multiple Myeloma (MM), analyze factors influencing surgical outcomes, and develop a preliminary treatment decision framework for these patients. A retrospective analysis was conducted on clinical data from 35 MM patients who underwent separation surgery for ESCC graded ≥ 2 between 2013 and 2018. Patient data, including baseline information, surgical details, complications, and pre-operative as well as one-month post-operative efficacy evaluation indicators were recorded. Statistical analysis was performed on pre-operative and post-operative efficacy indicators to determine if there were significant improvements (p < 0.05). Ordered logistic regression was utilized to assess factors associated with an unfavorable post-operative quality of life outcome. Compared to pre-operative values, at one-month post-surgery, patients showed significant improvements in Frankel Score Classification (4 vs 5, p < 0.05), Karnofsky Performance Score (30 vs 70, p < 0.05), and Visual Analogue Scale (8 vs 3, p < 0.05). Complications occurred in 7 cases (20

Intracranial electrical stimulation (iES) of auditory cortex can elicit sound experiences with a variety of perceived contents (hallucination or illusion) and locations (contralateral or bilateral side), independent of actual acoustic inputs. However, the neural mechanisms underlying this elicitation heterogeneity remain undiscovered. Here, we collected subjective reports following iES at 3062 intracranial sites in 28 patients (both sexes) and identified 113 auditory cortical sites with iES-elicited sound experiences. We then decomposed the sound-induced intracranial electroencephalogram (iEEG) signals recorded from all 113 sites into time-frequency features. We found that the iES-elicited perceived contents can be predicted by the early high-γ features extracted from sound-induced iEEG. In contrast, the perceived locations elicited by stimulating hallucination sites and illusion sites are determined by the late high-γ and long-lasting α features, respectively. Our study unveils the crucial neural signatures of iES-elicited sound experiences in human and presents a new strategy to hearing restoration for individuals suffering from deafness.

OBJECTIVE:According to International Lymphology Society guidelines, the severity of lymphedema is determined by the difference in volume between the affected limb and the healthy side divided by the volume of the healthy side. However, this method of measuring volume is time consuming, laborious, and has certain errors in clinical applications. Therefore, this study aims to explore whether machine learning radiomics features based on noncontrast magnetic resonance imaging (MRI) can predict the severity of primary lower limb lymphedema. METHODS:A retrospective analysis of 119 patients with primary lower limb lymphedema. The enrolled patients were divided into a nonsevere group (mild and moderate) and a severe group. Using the semiautomatic threshold method in ITK-snap software on the patient's noncontrast MRI, we filled the area between the subcutaneous tissue and muscle of the edematous site. The PyRadiomics software package was used to extract radiomic features. The radiomic features were analyzed using the t test or Mann-Whitney test. Subsequently, Pearson correlation testing and least absolute shrinkage and selection operator screening were performed. Using Scikit-learn, the remaining features were used to construct five models: logistic regression, support vector machine, random Forest, ExtraTrees, and light gradient boosting machine. The predictive performance were evaluated by the receiver operating characteristic curve, and the sensitivity and specificity of these measures were calculated. The predictive curve was used to evaluate the performance of the predictive model in guiding decisions for nonsevere and severe lymphedema patients. RESULTS:The enrolled patients including 28 patients with mild lymphedema (grade I), 38 patients with moderate lymphedema (grade II), and 53 patients with severe lymphedema (grade III) was conducted. A total of 1196 features were extracted, and after Pearson correlation testing and least absolute shrinkage and selection operator screening, 21 nonzero features were selected. The ExtraTree model performed the best, with an area under the curve of 0.974 (95% confidence interval, 0.9437-1.0000) in the training set, a sensitivity of 89.2%, and a specificity of 95.7%. In the test set, these values were 0.938 (95% confidence interval, 0.8539-1.0000), 75%, and 100%, respectively. The decision curve showed that when the predicted probability was between 16% and 78%, the net benefit of the ExtraTree model was greater than that of the two extreme curves, indicating strong clinical value in guiding decisions for nonsevere and severe lymphedema patients. CONCLUSIONS:All five models performed well in distinguishing between the nonsevere group and the severe group. Noncontrast MRI-based machine learning radiomics signature can predict the severity of primary lower limb lymphedema.

PURPOSE:The dermal rim sign (DRS) on nonenhanced magnetic resonance imaging has been shown to predict dermal backflow (DBF) in patients with secondary upper limb lymphedema. However, whether the DRS has the same effects on primary lower extremity lymphedema (PLEL) has not been clearly reported. Therefore, this study aimed to explore whether the DRS can be used to diagnose DBF on lymphoscintigraphy in patients with PLEL. METHODS:A total of 94 patients who were diagnosed with PLEL were recruited for this retrospective study from January 2022 to December 2023. All the patients were divided into two groups according to the lymphoscintigraphy findings: no DBF and DBF. The magnetic resonance imaging data of the two groups were recorded and statistically compared for the following indicators: range of lymphedema involvement (left, right, whole lower limbs, only thigh, only calf and ankle), signs of lymphedema (notable thickening of skin, parallel line sign, grid sign, honeycomb sign, band sign, lymph lake sign, crescent sign, DRS), and lymphedema measurement (skin thickness, band width). The DRS is characterized by notable thickening of the skin plus the grid sign and/or honeycomb sign, plus the band sign. RESULTS:The following statistically significant differences in the following indicators were found between the two groups (P < .05): notable skin thickening, parallel line sign, grid sign, honeycomb sign, band sign, DRS, skin thickness, and band width. The sensitivity, specificity, and accuracy for predicting for DBF with the DRS was 82%, 64%, and 77%, respectively. CONCLUSIONS:This study confirmed good consistency between the DRS and DBF from the perspective of imaging. This tool is suitable for children, adolescents, and patients with contraindications to lymphoscintigraphy. The DRS has important value in assessing the severity of PLEL. The DRS is suggested for the clinical use of combined surgical treatment of PLEL.

Visual perception is more than just a passive process of receiving environmental stimuli. It arises from the complex interaction with sensory input and the brain's pre-existing state [1–4]. The pre-stimulation state, particularly the cortical excitability, plays a crucial role in how we consciously perceive stimuli with near-threshold intensity [5]. One of the most direct methodologies to assess cortical excitability is to measure neurons' spontaneous firing rates prior to stimulus presentation [4].

Objective To retrospectively analyze the efficacy and prognostic factors of surgery in patients with epilepsy secondary to ganglioglioma. Methods Retrospective analysis was conducted on the clinical data of patients epilepsy secondary to ganglioglioma who underwent surgery and pathologically confirmed to be ganglioglioma in Kunming Sanbo Brain Hospital from January 2014 to August 2020. Regular follow-up was performed. The risk factors affecting the prognosis of epilepsy were predicted by statistical analyzing the patient’s medical history, imaging manifestations, surgical resection scope, etc. Results There were 35 patients who underwent surgery and confirmed as ganglioglioma by postoperative pathology.The mean follow-up was 46.67 months. Among them, 28 patients achieved Engle Ⅰ class outcome, and 7 patients achieved Engle Ⅱ-Ⅲ class outcome.There was no recurrence of tumor after surgery. The clinical characteristics of 35 patients were analyzed by multivariate statistics. The disease course was statistically significant for the prognosis of epilepsy. Conclusion Ganglioglioma is prone to induce secondary epilepsy. Early diagnosis and early surgery are required for good prognosis. The disease course is an independent risk factor for the prognosis of secondary epilepsy to ganglioglioma.

脑深部电刺激(DBS)是治疗药物难治性震颤的主要手术方式，丘脑腹中间核(VIM)是手术首选靶点。近年来，丘脑底核后部(PSA)也逐渐应用于临床，并被认为是一个有潜力的靶点。2020年6—10月昆明三博脑科医院神经外科通过双侧单电极双靶点电刺激即VIM联合PSA-DBS对2例震颤患者进行了手术治疗，术后效果良好，证实了该手术的可行性，通过程控发现，PSA对震颤控制更理想。

目的 探讨脑膜血管瘤病(MA)致难治性癫痫的手术疗效.方法 回顾性分析2例经病理证实为MA患者的临床资料.病例1患者间歇期脑电图为正常脑电图,但患者存在明确临床发作;病例2患者同时并发灰质异位;二者均在术中皮层脑电监测下行病灶切除.结果 手术过程顺利,术后恢复良好,术后随访1年为Engle Ⅰ级,生活质量较前提高.结论 手术治疗MA引起的难治性癫痫有确定疗效.

目的 探究磁共振成像(MRI)对子宫内膜癌组织学分级的价值.方法 回顾性分析首都医科大学附属北京世纪坛医院2017年至2020年经手术证实的64例子宫内膜癌患者的MRI图像,分别在横轴位与正中矢状面测量肿瘤及子宫的最大左右径、前后径及头足径,根据简化的椭球体积公式计算出肿瘤及子宫体积并计算两者比值(N/U).以病理学所见为金标准,应用非参数检验(Kruskal?Wallis检验)与单因素方差分析比较不同组织学级别(G1、G2、G3)子宫体积、肿瘤体积及N/U的差异.根据肿瘤浸润肌层深度与5年生存率将G1、G2、G3肿瘤分为高级别组与低级别组.应用受试者操作特征曲线(ROC曲线)分析两个组别的N/U在术前预测肿瘤组织学分级中的价值.结果 64例子宫内膜癌中G1级20例,G2级24例,G3级20例,三组之间肿瘤体积差异无统计学意义(H=3.528,P=0.171).G1级、G2级及G3级肿瘤的N/U值分别为(0.13±0.07)、(0.19±0.06)和(0.21±0.08),三者间差异具有统计学意义(F=9.04,P<0.01).高级别组与低级别组差异无统计学意义.以N/U值0.16为截断值区分G1肿瘤和G2/G3肿瘤,其曲线下面积(AUC)为0.80,敏感度为79.5％,特异度为80％.结论 MRI对子宫内膜癌组织学分级具有一定诊断价值.

Rationale: Serotonin (5-hydroxytryptamine, 5-HT) is generally considered to be involved in colitis-associated cancer (CAC), but previous research has yielded inconsistent results regarding the effect of 5-HT on CAC. 5-HT2B is one of the receptors of 5-HT, and the receptor is expressed in intestinal epithelial cells (IECs). However, the functions of 5-HT2B in CAC remain unclear. Our work demonstrates the variable functions of 5-HT/5-HT2B signaling in the initiation and progression of CAC in mice. Methods: We constructed two types of mutant mice homozygous knockout of Htr2b, the gene encoding 5-HT2B, in IECs (Htr2bΔIEC and Htr2bΔIEC-ER) to study the role of 5-HT2B in AOM/DSS-induced CAC model. Inflammation was measured using the body weight, colon length, and colitis severity score, and by histologic analysis of colon tissues. Tumor severity was assessed by tumor quantity, load, and histologic analysis of colon tumor tissues. Results: In Htr2bΔIEC mice, AOM/DSS induced an enhancement of colitis and tumor severity. This process was due to the inhibition of TGF-β/SMAD signaling pathway and activation of IL-6/STAT3 signaling pathway. IL-6 antibody treatment reversed the stimulating effect of Htr2b deletion on tumorigenesis. However, tumor severity decreased in Htr2bΔIEC-ER mice injected with tamoxifen on day 48 of AOM/DSS treatment. Knockout Akt1 eliminated the function of 5-HT in promoting tumor cells. Conclusion: Our work elucidates 5-HT/5-HT2B/TGF-β signaling as a critical tumor suppressing axis during CAC initiation but as a promoter of cancer progression in the late-stage of CAC. Our findings provide a new understanding of the role of 5-HT in the initiation and progression of CAC, offering a new perspective on the long-standing debate on whether the 5-HT signal promotes or inhibits tumors.

目的 观察以不同b值获得的表观弥散系数(ADC)直方图参数鉴别甲状腺良、恶性结节的效能.方法 回顾性分析43例单发甲状腺结节患者,术后病理确诊良性22例(良性组)、恶性21例(恶性组);将其术前5个b值(0、200、400、600和990 s/mm2)弥散加权成像(DWI)图导入ITK-snap软件,于b值为990 s/mm2的DWI上手动勾画ROI,利用自编程序分别计算ROI内不同b值的ADC百分位数(ADC 5％、25％、50％、75％、95％)、平均值、偏度及峰度,绘制直方图曲线;以受试者工作特征(ROC)曲线分析ADC直方图参数鉴别甲状腺良、恶性结节的效能.结果 b值为400、600、990 s/mm2时,良性组ADC 5％、50％、75％ 及平均值均高于恶性组(P均<0.05);b值为200、400、600、990 s/mm2时,良性组ADC 25％ 高于恶性组(P均<0.05);b值为600、990 s/mm2时,良性组ADC 95％ 高于恶性组(P均<0.05);其余参数组间差异均无统计学意义(P均>0.05).上述组间差异具有统计学意义的ADC直方图参数中,b值为990 s/mm2时的ADC平均值鉴别良、恶性结节的曲线下面积(AUC)最大,为0.751;b值为990 s/mm2时的ADC平均值、ADC 95％ 的诊断敏感度最高,均为81.04％;b值为990 s/mm2时的ADC 50％ 诊断特异度最高,为86.43％.结论 b值为200、400、600尤其990 s/mm2获得的ADC直方图参数可用于鉴别甲状腺良、恶性结节.

目的 探讨神经节细胞胶质瘤的脑电图特点及手术预后的相关因素.方法 回顾2014年7月至2020年12月昆明三博脑科医院神经外科诊治的35例经手术切除并病理证实神经节细胞胶质瘤患者的病例资料并进行分析总结,定期随访,并通过对患者的术前脑电图、影像学检查、病史等进行统计分析,预测影响癫痫预后的因素.结果 神经节细胞胶质瘤放电的部位与病变部位一致,且与病灶及周边相关.35例患者中,正常脑电图3例(9％)、异常脑电图32例(91％),其中,2例仅有慢波活动,30例记录到间期放电,19例记录到癫痫发作.脑电图存在3种间期放电模式和3种发作期放电模式,间期放电常见模式为脑区性棘慢复合波、尖慢复合波(53％),发作期常见模式为低电压快活动(53％).术后平均随访46.67个月,28例为EngelⅠ级(80％),7例为EngelⅡ～Ⅲ级(20％),术后复查肿瘤无1例复发.对35例患者的临床特点及脑电图进行多因素统计学分析发现,病程对于癫痫预后具有统计学意义.结论 脑电图结合影像学检查可提高癫痫患者致痫灶定位的准确性.对于神经节细胞胶质瘤导致癫痫发作的患者,手术切除病灶可有效治愈癫痫.

Adenocarcinoma is the most prevalent histological subtype of colorectal cancer (CRC), with mucinous colorectal adenocarcinoma (MCA) being a unique form. Although the mucinous subtype is known to elicit a worse response to chemotherapy and immunotherapy than the nonmucinous subtype, its pathogenesis remains poorly understood. Neurogenic locus notch homolog protein 3 (NOTCH3), a member of the NOTCH subfamilies, is highly expressed in CRC. In the past three decades, many studies have been performed evaluating the biological role of NOTCH3 in CRC. However, the precise activities of NOTCH3 in MCA, as well as the mechanisms involved in its transcriptional control, are yet to be elucidated. Our finding showed that the critical transcriptional regulatory factor transcription activator BRG1 (SMARCA4) directly binds to the intracellular domain of NOTCH3 to control transcriptional regulation. Moreover, RNA‐sequencing results indicated a common targeting effect on the transcriptional activity of mucin‐5AC ( MUC5AC ) and mucin‐2 ( MUC2 ) in CRC cells by NOTCH3 and SMARCA4. Furthermore, NOTCH3 was found to control the expressions of MUC5AC and MUC2 in a SMARCA4‐dependent manner. MUC5AC and MUC2 , which encode two secreted mucins, are located on chromosome 11p15.5, and are linked to the development of MCA. This finding suggests that the interaction between NOTCH3 and SMARCA4 may be involved in MCA differentiation by jointly targeting MUC5AC and MUC2 . Patients with MCA are often treated in accordance with CRC guidelines. Determining the relationship between NOTCH3 and SMARCA4 by demonstrating their interactions in the pathophysiology of MCA could provide novel therapeutic targets and help identify potential prognostic markers for MCA.

Objectives To explore the clinical value of subendometrial enhancement (SEE), irregular thin-layered peritumoral early enhancement (ITLPE) and focal irregular peritumoral early enhancement (FIPE) on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for myometrial invasion in patients with low-risk endometrial carcinoma. Methods Seventy-seven patients with low-risk endometrial carcinoma who preoperatively underwent DCE-MRI were included. Two radiologists independently evaluated and recorded the occurrences of SEE, ITLPE and FIPE on DCE-MRI in all patients. Interobserver agreement was calculated between the two radiologists, and the relationships between SEE, ITLPE, FIPE, and myometrial invasion were analyzed based on histologic findings. For statistically significant findings, the sensitivity and specificity were calculated, and the differences in myometrial invasion evaluations were analyzed. For those with no statistical significance, images were compared with the histopathologic sections. Results Inter-observer agreement was good (k = 0.80; 95%CI, 0.577–0.955) for SEE, and very good (k = 0.88; 95%CI, 0.761–0.972) (k = 0.86; 95%CI, 0.739–0.973) for ITLPE and FIPE. After consensus, SEE was identified in 12/77 (15.6%) patients; ITLPE and FIPE were found in 53/77 (68.8%) and 30/77 (39.0%) patients, respectively. SEE and ITLPE were significantly correlated with myometrial infiltration (P = 0.000), but FIPE were not (P = 0.725).The sensitivity and specificity of SEE and ITLPE for myometrial invasion in patients with low-risk endometrial carcinoma were 95.0 and 52.9%, and 85.0 and 88.0%, respectively. The area under the curve (AUC) of SEE and ITLPE for myometrial invasion were 0.740 (95%CI, 0.584–0.896), and 0.866 (95%CI, 0.763–0.970), respectively. The sensitivity and specificity were statistically different between SEE and ITLPE for the detection of myometrial invasion (P = 0.031, 0.016). According to the comparison between FIPE and histopathologic findings, the irregular endomyometrial junction was found in 30/77 (38.9%) cases, 24/30 (80.0%) with myometrial infiltration and 6/30 (20.0%) cases without myometrial infiltration. Conclusions FIPE was the irregular endomyometrial junction. It can be found in patients with or without myometrial infiltration and may lead to the overestimation of myometrial invasion by SEE on DCE-MRI. ITLPE presented high diagnostic performance and specificity for myometrial invasion in patients with low-risk endometrial carcinoma.

目的 探讨MRI动态增强黏膜下强化带评估子宫内膜癌肌层侵犯的准确性及不同瘤周强化模式的临床价值.方法 搜集影像资料完整并经手术病理证实的75例子宫内膜癌患者对其MRI动态增强图像进行回顾性分析.由2名影像科医师评估每例黏膜下强化带的完整性及瘤周强化模式(瘤周早期局灶性强化和瘤周早期不规则薄层强化)并记录,以手术病理为金标准,评价黏膜下强化带中断诊断肌层侵犯的敏感度、特异度及准确率,分析两种瘤周强化模式与肌层侵犯的关系.结果 黏膜下强化带中断诊断肌层侵犯的敏感度、特异度及准确率为96.5％、52.8％和86.6％;子宫内膜癌肌层有无侵犯在瘤周早期不规则薄层强化中差异有统计学意义(P =0.000),瘤周早期不规则薄层强化诊断肌层侵犯的敏感度、特异度及准确率为72.4％、88.2％和76.0％.结论 瘤周早期局灶性强化可能是造成MRI动态增强黏膜下强化带对肌层侵犯高估的重要因素;瘤周早期不规则薄层强化在诊断肌层浸润上可能具有重要提示价值.

目的 观察拉考沙胺(lakosamine,LCM)治疗局灶性癫痫患者的临床疗效.方法 收集2019年3月-2020年7月昆明三博脑科医院和昆明医科大学第一附属医院服用拉考沙胺治疗局灶性癫痫患者53例,最终纳入44例,服用拉考沙胺时间超过6个月.2021年2月对44例患者发作情况及耐受性进行随访并分析.结果添加LCM药物后,对服药至少6个月患者随访,患者癫痫发作频率显著减少,差异具有统计学意义(P＜0.01),有效率可达81.81％,保留率达83％.结论 拉考沙胺作为第三代新型抗发作药物,对于局灶性癫痫患者能有效减少癫痫发作频率.极少数患者出现不良反应不可耐受情况.

目的:探讨多参数磁共振成像(mpMRI)在鉴别颈部淋巴结良恶性中的应用价值.方法:选取在医院行MR检查初诊颈部淋巴结病变的34例患者,将其经手术、穿刺病理或随访证实的95枚颈部淋巴结依据淋巴结病理结果分为良性淋巴结组(51枚)和恶性淋巴结组(44枚).分析颈部良、恶性淋巴结MRI平扫影像特征、表观弥散系数(ADC)值及动态增强扫描时间-信号曲线类型、达峰时间等指标间的差异,绘制受试者工作特征(ROC)曲线,比较不同检查技术间的敏感性、特异性及ROC曲线下面积(AUC).结果:恶性淋巴结组淋巴结平均长径、短径均大于良性淋巴结组,差异有统计学意义(t=2.287,t=2.637;P<0.05);恶性淋巴结组平均ADC值低于良性淋巴结组,差异有统计学意义(t=2.702,P<0.05);颈部良性淋巴结时间-信号曲线多为B型,恶性淋巴结则以A型为主;颈部良性淋巴结组的平均达峰时间明显早于恶性淋巴结组,差异有统计学意义(t=40.983,P<0.05).mpMRI鉴别颈部淋巴结良、恶性的敏感性及特异性均高于弥散加权成像(DWI)、动态增强扫描序列.AUC的mpMRI>动态增强扫描>DWI成像,三者间差异有统计学意义(Z=5.247,P<0.001).结论:mpMRI能够提供更加全面的形态学及血流动力学等信息,综合分析能够提高颈部淋巴结定性诊断的准确性.

Microvascular decompression is the first choice for treating the primary trigeminal neuralgia to provide the most extended duration of pain freedom. However, in microvascular decompression, we found that this kind of operation is only suitable for some patients. It is of great value to objectively judge the function and abnormality of the trigeminal pain conduction pathway in guiding the operation process. This brief report investigates the value of pain evoked potential by electrical stimulation and noceciptive blink reflex in trigeminal neuralgia. We detected the pain evoked potential in 34 patients with trigeminal neuralgia and 48 healthy controls treated by electrical stimulation and blink reflex. We demonstrated no significant differences in the latencies of V-1, V-2, V-3, and R-2 of the affected side and the contralateral side in patients with trigeminal neuralgia. The latencies of those four indicators of the affected side in patients with trigeminal neuralgia were notably decreased compared to those on the same side in healthy controls. The receiver operating characteristic curve analysis showed that the area under curve, sensitivity and specificity of the combined diagnosis of latency and amplitude were significantly higher than the single diagnosis. The latency and amplitude of V-1 were highly sensitive, while those of V-2 was highly specific. Trigeminal neuralgia can be effectively diagnosed by combining pain evoked potential by electrical stimulation and noceciptive blink reflex. The pathogenesis of trigeminal neuralgia should be combined with peripheral pathogenicity and the theory of central pathogenicity.