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| The assessment of morphological changes of the trigeminal nerves in primary trigeminal neuralgia and its correlation with the extent of pain by the contrast-enhanced 3D FLASH and 3D CISS sequences |
| YANG Dengfa1, WANG Linyou1, YANG Tiejun1, LI Junmiao1, SHEN Jianmin1, WU Liang1, JIN Yong2, ZHOU Kaiyu2, LI Youcheng3. |
| 1.Department of Radiology, Taizhou Municipal Hospital, Taizhou, 318000; 2.Department of Neurological Surgery, Taizhou Municipal Hospital, Taizhou, 318000; 3.Department of Radiology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325015 |
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YANG Dengfa,WANG Linyou,YANG Tiejun, et al. The assessment of morphological changes of the trigeminal nerves in primary trigeminal neuralgia and its correlation with the extent of pain by the contrast-enhanced 3D FLASH and 3D CISS sequences[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2018, 48(9): 662-666.
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Abstract Objective: To assess the morphologic changes in the primary trigeminal neuralgia with the high-resolution MR imaging, and to evaluate the correlation between the degrees of neurovascular compression and the extent of pain. Methods: Forty-eight patients with trigeminal neuralgia undergoing the enhanced three-dimensional fast low angle shot (3D-FLASH) and three-dimensional constructive interference in steady-state (3D-CISS) sequence were retrospectively analyzed. The length and area of the cisternal segment of the trigeminal nerve, the trigeminal-pontine angle and the cross-sectional area of cerebellopontine angle cistern were measured. The vascular compression was classified into three degrees: degree I, no contact; degree II, contact or suspicious; degree III, compression. The extent of pain was measured by visual analog score. Results: There were 8 cases in degree I, 28 cases in degree II, and 12 cases in degree III. The length of the cisternal segment of the affected side and the healthy side was (9.17±3.30) mm and (9.53±2.50) mm respectively, showing no statistical difference (P>0.05). The area of the cisternal segment of the affected side and the healthy side was (19.78±6.95) mm2 and (26.37±13.20) mm2 respectively, showing significant difference (P<0.05). The trigeminal-pontine angle of the affected side and the healthy side was 40.02°±14.43° and 52.57°±16.10° respectively, showing statistical difference (P<0.05). The cross-sectional area of cerebellopontine angle cistern of the affected side and the healthy side was (191.75±68.75) mm2 and (236.74±64.79) mm2 respectively, showing statistical difference (P<0.05). Positive correlation could be found between the degrees of NVC and the extent of pain in the patients with TN (P=0.033, r=0.309). Conclusion: The morphologic changes can be diagnosed qualitatively and quantitatively with the high-resolution MR imaging. Sharp trigeminal-pontine angle, narrow area of the cerebellopontine angle cistern increase the chance of neurovascular contact, and cause TN easily. There is correlation between the degrees of NVC and the extent of pain in the patients with TN.
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Received: 06 February 2018
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