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Objective To determine the anatomical characteristics of the petrous ridge and trigeminal nerve in trigeminal neuralgia (TN) without neurovascular compression (NVC). Materials and Methods From May 2017 to March 2021, 66 patients (49 female and 17 male; mean age ± standard deviation [SD], 56.8 ± 13.3 years) with TN without NVC and 57 controls (46 female and 11 male; 52.0 ± 15.6 years) were enrolled. The angle of the petrous ridge (APR) and angle of the trigeminal nerve (ATN) were measured using magnetic resonance imaging with a high-resolution three-dimensional T2 sequence. Data on the symptomatic side were compared with those on the asymptomatic side in patients and with the mean measurements of the bilateral sides in controls. Receiver operating characteristic (ROC) analysis was conducted to evaluate the performance of APR and ATN in distinguishing TN patients from controls. Results In TN patients without NVC, the mean ± standard deviation (SD) of APR on the symptomatic side (98.40° ± 19.75°) was significantly smaller than that of the asymptomatic side (105.59° ± 22.45°, p = 0.019) and controls (108.44° ± 15.98°, p = 0.003). The mean ATN ± SD on the symptomatic side (144.41° ± 8.92°) was significantly smaller than that of the asymptomatic side (149.67° ± 8.09°, p = 0.003) and controls (150.45° ± 8.48°, p = 0.001). The area under the ROC curve for distinguishing TN patients from controls was 0.673 (95% confidence interval [CI]: 0.579–0.758) for APR and 0.700 (CI: 0.607–0.782) for ATN. The sensitivity and specificity using the diagnostic cutoff yielding the highest Youden index were 81.8% (54/66) and 49.1% (28/57), respectively, for APR (with a cutoff score of 94.30°) and 65.2% (43/66) and 66.7% (38/57), respectively, for ATN (cutoff score, 148.25°). Conclusion In patients with TN without NVC, APR and ATN were smaller than those in controls, which may explain the potential cause of TN and provide additional information for diagnosis.

Background To retrospectively evaluate Doppler ultrasound findings for patients with popliteal vascular entrapment syndrome (PVES). Methods Twenty-four patients (30 legs) who underwent surgical intervention for PVES were included in this study. The popliteal artery, popliteal vein, and surrounding musculotendinous structures were explored in all symptomatic lower extremities using ultrasound. Intraoperative findings served as the gold standard. In the absence of popliteal artery occlusion, popliteal arteries were examined using Doppler ultrasound at rest and during a provocative maneuver. Results Ultrasonography in 25 cases (25/30, 83%) showed that gastrocnemius medial head or popliteal vascular anomalies were consistent with surgical photography results. According to Whelan and Rich classification, the classic type I was found in five limbs, type II in twelve limbs, type III in seven limbs, and type V in one limb. In the remaining five cases (5/30, 17%), no anatomical abnormalities of the popliteal fossa were discovered by the ultrasound examination. Among these, two cases (2/30, 7%) were misdiagnosed as lower extremity atherosclerosis and popliteal vascular depression was not found. In addition, increasing blood flow velocity was found in three cases (3/30, 10%) of compressed popliteal arteries using Duplex scanning during active plantar flexion, with decreasing flow at the distal end. Color Doppler ultrasound of the affected popliteal vessels showed varied degrees of vascular structure pathology, including arterial stenosis in ten limbs, occlusion in fifteen limbs, and aneurysm in two limbs. Conclusion Doppler ultrasound may have a high diagnostic rate in PVES. Due to its simplicity, repeatability, functional evaluation of blood flow, and non-invasiveness, it can be used as a primary screening examination modality in PVES. Provocative maneuvers could help clinicians diagnose PVES.

The main purpose was to evaluate the gamma knife radiosurgery(GKRS) treatment effect of multiple kinds of brain tumors by MR perfusion imaging. We collected 45 patients with three kinds of brain tumors treated with GKRS. Perfusion imaging, including 3D-ASL and DSC-PWI, was performed before and after treatment. ASL-rCBF, DSC-rCBF and DSC-rCBV decreased significantly after GKRS treatment, and ASL-rCBF before GKRS treatment showed the most robust performance with high AUC in predicting GKRS treatment effect. With these findings, MR perfusion imaging can be considered a time and effective method understanding the treatment effect of GKRS for brain tumor patients.