Targeting Vascular Cross Compression of Cranial nerves by MRI - Comparing different techniques for the diagnosis, characterization, and identification of prognostic factors

Abstract

Conclusion: Heavy T 2-weighted MRI 3D driven equilibrium (DRIVE) is superior to 3D bFFE sequence in detecting neurovascular compressions, depicting their pattern and evaluating nerve morphology. Objective: Compare 3D driven equilibrium (DRIVE) and 3-dimensional (3D) balanced fast-field echo (bFFE) MRI in detecting, and characterizing neurovascular cross compression as regards cause, type and effect on the affected nerve. Patients and Methods: Forty-eight patients with clinical suspicion of vascular loop compression syndromes underwent MRI scans. There were 29 patients with audiovestibular symptoms, 12 with hemifacial spasm, 6 with trigeminal neuralgia and 1 with glossopharyngeal neuralgia. The cause and pattern of compression were compared on 3D driven equilibrium (DRIVE) and 3D bFFE images. The mean diameter of the involved nerve was compared to normal side. The MRI findings were compared to surgical findings in 42 cases. Results: MRI outlined the conflict in 43/48 scanned patients (89.58%). 3D DRIVE revealed more anatomical details and more insulting vessels than 3D bFFE sequence (p < 0.05). As regards the offending vessel the concordance of MRI with surgical findings was 38/42 (84.4%) . There was strong correlation (p < 0.001) between pre-operative MRI findings and intra-operative findings regarding the type of VCC, and nerve affection.