Trigeminal neuralgia: comparison of two MR imaging techniques in the demonstration of neurovascular contact.

Severity Analysis of Neurovascular Contact in Patients with Trigeminal Neuralgia: Assessment with the Inner View of the 3D MR Cisternogram and Angiogram Fusion Imaging

“…[3][4][5][6][7][8][9][10][11][12] Symptomatic NVC is often found at the affected trigeminal nerve, but asymptomatic NVC is also detected at the contralateral and normal trigeminal nerves. 3,4,6 Regarding the MR imaging findings of the NVC, it remains to be clarified whether the NVC by an artery or a vein at the trigeminal nerve root entry zone causes TN.…”

“…[3][4][5][6][7] We have developed the fusion imaging technique to depict the NVC by 3D image reconstruction 8,9 and have applied it in patients with neurovascular compression syndrome, including those with hemifacial spasms, glossopharyngeal neuralgia, and TN. In the present study, we have newly reconstructed the inner view of fusion MR imaging to assess the fine morphologic change in the affected trigeminal nerve just at the site of the NVC; the anatomic relationship of the NVC is projected along the nerve axis from the rootlet toward the orifice of the Meckel cave.…”

“…Although a simple NVC may not be sufficient to explain the cause of TN, any degree of NVC in the affected trigeminal nerve may cause TN. [1][2][3][4][5]9 Additionally, the NVC in the patients who underwent surgery for TN was more severe than that in patients with medical treatment (P Ͻ .01, Mann-Whitney U test). Prediction of the severity of the NVC with an inner view of the fusion MR imaging does not mean that MVD surgery is necessary, but it may provide useful information in selecting patients who are insufficiently responsive to medical treatment and most likely to benefit from MVD surgery.…”

“…1,2 Recent advances in MR imaging have provided us with fine volumetric data regarding the anatomic elements composing the NVC. [3][4][5][6][7][8][9][10][11][12] NVC is often detected on the affected side of TN (affected trigeminal nerve), though it is not infrequently observed in the asymptomatic nerve contralateral to the affected side (contralateral trigeminal nerve), as well as in the normal trigeminal nerve in a control subject without TN (normal trigeminal nerve). 3,4,6 The significance of the MR imaging findings of the NVC has not been established, and it remains unclear whether the NVC is symptomatic and linked to cause TN or asymptomatic and observed incidentally.…”

MR cisternography in the posterior fossa: the evaluation of trigeminal neurovascular compression

“…As a result, it significantly improves the resolution of nerves and vessels in the posterior cranial fossa (19,23). Compared with the conventional T2WI, MRC has more advantages in displaying NVC, and it provides valuable information for treatment protocols of micro-neurosurgery on trigeminal neuralgia (2, 8,9,13,14,16,18,20).…”