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:: Volume 20, Issue 1 (1-2022) ::
Int J Radiat Res 2022, 20(1): 67-73 Back to browse issues page
The evaluation of neurovascular relationships in trigeminal neuralgia: a pilot study on the optimal combination of high-resolution three-dimensional MR sequences
W. Jiang, B. Liu, Y. Liu, J. Wang, Q. Ding, H. Ji, Y. Cui, Y. Wang, Q. Pang, Q. Zeng
Department of Radiology, Qianfoshan Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, China , qingshizeng@outlook.com
Abstract:   (767 Views)
Background: To explore the efficacy and optimal modality of three-dimensional (3D) MRI sequences in the preoperative detection of neurovascular compressions (NVCs) in patients with trigeminal neuralgia (TN). Materials and Methods: Forty-nine cases of typical unilateral TN had undergone 3D time-of-flight magnetic resonance angiography (3D-TOF MRA), 3D fast imaging employing steady-state acquisition (3D-FIESTA), and contrast-enhanced 3D spoiled gradient-recalled sequence (3D-SPGR) on a 3 Tesla MR scanner. Neurovascular relationships (including neurovascular contact and position and the nature of the offending vessels) on MR images were reviewed by a neuroradiologist who was unaware of the clinical findings. Subsequently, microvascular decompression (MVD) surgery was performed on all patients. Comparison was made between the imaging results and surgical findings. Results: MVD verified NVC in 48 (98%) symptomatic nerves, while 3D-TOF MRA, 3D-FIESTA, and 3D-SPGR revealed NVC in 38 (78%), 48 (98%), and 47 (96%) cases, respectively. Agreement between the position of NVC, as defined by 3D-FIESTA (κ = 0.86) or 3D-SPGR (κ = 0.83) and surgical findings, was excellent. Moreover, excellent agreement was confirmed between the nature of compressing vessels as defined by 3D-FIESTA in combination with 3D-TOF MRA (κ = 0.95) or contrast-enhanced 3D-SPGR in combination with 3D-TOF MRA (κ = 0.92) and surgical findings. Conclusions: NVCs were visualized with good sensitivity and specificity with 3D MRI sequences in TN. We propose that 3D-FIESTA combined with 3D-TOF MRA is a safe, convenient, and efficacious MRI sequence for revealing NVCs and is crucial for the preoperative diagnosis and surgical planning of MVD.
Keywords: Trigeminal neuralgia, Magnetic resonance, Neurovascular compression, Facial pain, Microvascular decompression.
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Type of Study: Original Research | Subject: Radiobiology
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Jiang W, Liu B, Liu Y, Wang J, Ding Q, Ji H, et al . The evaluation of neurovascular relationships in trigeminal neuralgia: a pilot study on the optimal combination of high-resolution three-dimensional MR sequences. Int J Radiat Res. 2022; 20 (1) :67-73
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Volume 20, Issue 1 (1-2022) Back to browse issues page
International Journal of Radiation Research
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