A Combination of 3D TOF MRA and FIESTA Predicts Surgery-Needed Primary Trigeminal Neuralgia and Specific Offending Vessels

Abstract

Background: To investigate the predictive accuracy of three-dimension (3D) time-of-flight (TOF) MR angiography (MRA) and 3D Fast Imaging Employing Steady-state Acquisition (FIESTA) techniques in assessing neurovascular compression (NVC) with specific vessels in patients with primary trigeminal neuralgia (TN). Methods: Patients with single-site primary TN undergoing microvascular decompression (MVD) were retrospectively recruited. All patients had available preoperative magnetic resonance imaging (MRI) scans. A quantitative NVC scoring system was applied to assess the severity of NVC on MRI. The radiological findings were correlated with the intraoperative result to determine the diagnostic accuracy of MRI techniques. Besides, the radiological indicator of MVD was determined. Results: Seventy-three TN patients were recruited. Thirty-three patient had bilateral NVC but with unilateral neuralgia. The average NVC score of the asymptomatic side was significantly lower than that of the symptomatic side (1.6 vs. 6.7; p 4 was determined as a radiological indicator of MVD with sensitivity and specificity of 82.2% and 98.6%, respectively Area Under Curve (AUC = 0.97; p 4 is identified to predict TN, suggestive of subsequent surgical treatment.

Keywords

• trigeminal neuralgia
• mri
• neurovascular compression
• 3d tof
• fiesta
• microvascular decompression