The role of three-dimensional reconstruction with high-resolution magnetic resonance tomographic angiography in microyascular decompression and etiological study of trigeminal neuralgia

Abstract

Objective To analyze the role of high-resolution magnetic resonance tomographic angiography(MRTA)in microvascular decompression(MVD)and etiological study of trigeminal neuralgia(TN). Methods Craniocerebral MRI was performed in 84 cases with TN and three-dimensional time-of-flight(3D-TOF)MR angiography(MRA)using spoiled gradient-recalled-echo sequences was applied to observe the course of the trigeminal nerve and its relation to adjacent blood vessels. Among these cases, 68 underwent surgical treatment. MRI findings and intraoperative manifestations were analyzed comparatively and the correlation between TN and local vascular compression was also observed. Results MRI showed that the affected side blood vessels of 79 cases touched the trigeminal nerve and the intact side vessels of 12 cases touched the trigeminal nerve.Among the 68 cases undergoing MVD,62 had surgical results entirely consistent with MRI findings,4 had their relatively fine arteries oppressing the trigeminal nerve and 2 had petrosal vein compression combined with arachnoid adhesion. Conclusion Vascular compression at the root entry zone(REZ) of the trigeminal nerve is the one of the primary causes of TN.The technique of 3D-TOF MRA may determine the correlation between blood vessels and nerves in patients with TN,which is helpful for the diagnosis of etiological factors for TN and benefits MVD. Key words: Trigeminal neuralgia; Magnetic resonance angiography; Microvasculardecompression; Etiology