Journal of Pain Research (Nov 2021)
Predictability of Fused 3D-T2-SPACE and 3D-TOF-MRA Images in Identifying Conflict in Trigeminal Neuralgia
Abstract
Hong Duc Pham,1,2 Thu Ha Dang,1,2 Trung Kien Duong,3 Trung Thanh Dinh,1 Van Giang Bui,2,4 Tuan Vu Nguyen,5 Quang Huy Huynh6,7 1Radiology Department, Saint Paul Hospital of Hanoi, Hanoi City, Vietnam; 2Radiology Department, Hanoi Medical University, Hanoi City, Vietnam; 3Neurosurgery Department, Saint Paul Hospital of Hanoi, Hanoi City, Vietnam; 4Radiology Centre, National Cancer Hospital, Hanoi City, Vietnam; 5Cardiology Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam; 6Radiology Department, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam; 7Radiology Department, Trưng Vương Hospital, Ho Chi Minh City, VietnamCorrespondence: Tuan Vu NguyenCardiology Department, Pham Ngoc Thach University of Medicine, 2 Duong Quang Trung Street, Ho Chi Minh City, VietnamTel +84903627477Email [email protected]: To evaluate the efficacy of fused three-dimensional T2 sampling perfection with application-optimized contrasts using different flip-angle evolutions (3D-SPACE) and three-dimensional time-of-flight magnetic resonance angiography (3D-TOF-MRA) sequences for detecting neurovascular compression (NVC) in patients presenting with trigeminal neuralgia (TN).Methods: A prospective study was carried in 33 consecutive patients (m/f: 17/16; mean age, 56.3 ± 10.4 years) with unilateral TN confirmed NVC and consensus by two experienced radiologists on fused 3D-SPACE and 3D-TOF-MRA sequences of 3-tesla (3-T) MRI. All patients underwent microvascular decompression (MVD), using photos and video in surgery as documents compared with MRI. Both the MRI and MVD were reported for three grades (contact, compression, distortion), vessel types (artery or vein), identification of offending vessel, site (juxtapontine, cisternal, and juxtapetrous), and location (cranial, caudal, medial, lateral). Agreement between preoperative MRI visualization and surgical findings was assessed using the kappa (K) statistic.Results: The k-values for the agreement were excellent for the grade of NVC (k=0.82), vessel types (k=0.78), and location of conflict (k=0.74), and good for identification of the offending vessel (0.65) and the site-affected vessel (k=0.69).Conclusion: The fused D3-SPACE and 3D-TOF-MRA images are highly effective tools for the evaluation and treatment planning of NVC in TN patients.Keywords: trigeminal neuralgia, neurovascular conflict, magnetic resonance imaging, microvascular decompression
