Usefulness of Subtraction of 3D T2WI-DRIVE from Contrast-Enhanced 3D T1WI: Preoperative Evaluations of the Neurovascular Anatomy of Patients with Neurovascular Compression Syndrome

Masuda, Yuta; Yamamoto, Tetsuo; Akutsu, Hidenori; Shiigai, Masanari; Masumoto, T.; Ishikawa, Eiichi; Matsuda, Masayuki; Matsumura, Akira

doi:10.3174/ajnr.a4130

Cited by 9 publications

(3 citation statements)

References 27 publications

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“…For example, the T2-weighted 3D pulse with drive MRI sequences has been preliminary found to significantly improve the view of the CSF/spinal cord/roots interface, thus enhancing the possibility of detecting the intradural course of a sinus tract [39]. This technique has been used thus far for the visualization of cranial nerves and/or neurovascular conflicts [40, 41].…”

Section: Discussionmentioning

confidence: 99%

Acute presentations of intradural lipomas: case reports and a review of the literature

et al. 2019

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Background Lumbosacral lipomas (LLs) may remain asymptomatic or lead to progressive neurological deterioration. However, sudden neurological deterioration is a rare and severe event. Herein, we report rare occurrences of sudden clinical deterioration in two previously asymptomatic children harbouring intradural LLs without dermal sinus tracts or signs of occult dysraphism. A review of the pertinent literature is also included. Case presentation One child exhibited acute deterioration because of an epidural abscess associated with a filar lipoma without a sinus tract (probably caused by haematogenous spreading from a respiratory tract multiple infection), and the other child exhibited acute deterioration because of a very large, holocord syringomyelia-like cyst associated with a small conus lipoma. Both patients were 4 years old. In case #2, a previously undetected, severe tethered cord (conus at the S3-S4 level) was also present. A complete recovery was attained after an urgent surgical operation in both cases (in addition to targeted antibiotic therapy in case #1). All cases of deterioration in the literature were caused by abscess formation in dermal sinus tracts. Conclusions Prophylactic surgery may be indicated even in asymptomatic children that have tethered cord and surgically favourable LLs (small dorsal and filar LLs), especially if the conditions are associated with progressive syringomyelia. Similarly, intradural dermal sinus tracts should be regarded as surgery-indicated, even if the conus is in its normal position and the patient is asymptomatic because there is a consistent risk of severe, infection-related complications. Finally, asymptomatic patients with filar LLs and a normally located conus can be candidates for surgery or an accurate clinical and radiological follow-up.

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Section: Discussionmentioning

confidence: 99%

Acute presentations of intradural lipomas: case reports and a review of the literature

et al. 2019

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“…38 The types of MRI and sequences used to obtain diagnostic reliability have been analyzed in several publications. 8,27 Some authors rely on 3D high-resolution T2-weighted images, others advocate combining T2-weighted sequences with MR angiography, 5 and yet others prefer T2-weighted and T1-weighted sequences with gadolinium. On our part, we stress the importance of the 3 following sequences: high-resolution 3D T2-weighted sequences, TOF angiography, and 3D T1-weighted sequences with gadolinium to increase the sensitivity and improve the specificity.…”

Section: Discussionmentioning

confidence: 99%

Reliability of MRI for predicting characteristics of neurovascular conflicts in trigeminal neuralgia: implications for surgical decision making

Brînzeu

Drogba

Sindou

2018

Journal of Neurosurgery

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OBJECTIVEThe choice of microvascular decompression (MVD), among the several other surgical options, for treating refractory classical trigeminal neuralgia (TN) relies mostly on preoperative imaging, but the degree of reliability of MRI remains a matter of debate. The authors approached the question of predictability of neurovascular conflict (NVC) in a series of 100 protocolized MRI studies from patients with TN who underwent MVD, by reexamination of MR images, blinded to the clinical data and surgical findings, including the side of the neuralgia.METHODSPatients included in the study were those who underwent MVD after surgical indication had been determined based on a protocolized imagery workup (3D high-resolution T2-weighted cisternography centered on the trigeminal nerve, 3D time-of-flight angiography, and 3D gadolinium-enhanced T1-weighted imaging) performed at our institution. All MR images were blindly reexamined, and neurovascular relationships were described on both sides, noting the existence of compression, vessels involved, situation along the root, and degree of compression. The results of MRI evaluation were then compared with actual surgical findings. The extent of agreement and quality of the prediction were expressed with Cohen’s kappa coefficient (κ) and receiver operating characteristic (ROC) statistics.RESULTSA conflict had actually been found during surgery in 94 of 100 patients. The sensitivity of MRI to detect a conflict was 97% and the specificity was 50%. Vessel type was identified with high reliability (κ = 0.80), while the grade of the conflict and its situation along the root showed poor to average reliability (κ = 0.38 and κ = 0.40, respectively). The area under the ROC curve for predicting the presence of a conflict according to the grades of conflict seen on MRI was 0.93, which is considered very good. The positive predictive value was differentiated according to the grade of conflict, with a very high value for high grades of vascular conflict.CONCLUSIONSThis study shows an overall good reliability of MRI to predict the existence of an NVC. The prediction value is excellent for high grades of compression. Some apparent low-grade compressions on MRI may be revealed as false positives in surgical exploration. This raises the question of what other imaging methods might be used to determine not only the existence of a conflict but also its degree of compression. The degree of compression is of paramount importance to predict the probability of long-term pain relief, and therefore in the decision to propose MVD as the first choice of surgical treatment.

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“…However, they often exhibit limitations in achieving adequate contrast differentiation between blood vessels and cranial nerves precisely at the site of the NVC. To address this limitation, a method known as Subtraction of 3D T2-weighted Imaging-driven Equilibrium Radiofrequency Reset Pulse from Contrastenhanced 3D T1-weighted Imaging has been empirically demonstrated to provide both superior spatial resolution and outstanding contrast enhancement for depicting neurovascular compression [78]. Secondly, another valuable technique in three-dimensional MRI visualization is VE.…”

Section: Three-dimensional Magnetic Resonancementioning

confidence: 99%

The Anterior Inferior Cerebral Artery Variability in the Context of Neurovascular Compression Syndromes: A Narrative Review

Kościołek,

Kobierecki,

Tokarski

et al. 2024

Biomedicines

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The anterior inferior cerebellar artery (AICA) is situated within the posterior cranial fossa and typically arises from the basilar artery, usually at the pontomedullary junction. AICA is implicated in various clinical conditions, encompassing the development of aneurysms, thrombus formation, and the manifestation of lateral pontine syndrome. Furthermore, owing to its close proximity to cranial nerves within the middle cerebellopontine angle, AICA’s pulsatile compression at the root entry/exit zone of cranial nerves may give rise to specific neurovascular compression syndromes (NVCs), including hemifacial spasm (HFS) and geniculate neuralgia concurrent with HFS. In this narrative review, we undertake an examination of the influence of anatomical variations in AICA on the occurrence of NVCs. Significant methodological disparities between cadaveric and radiological studies (CTA, MRA, and DSA) were found, particularly in diagnosing AICA’s absence, which was more common in radiological studies (up to 36.1%) compared to cadaver studies (less than 5%). Other observed variations included atypical origins from the vertebral artery and basilar-vertebral junction, as well as the AICA-and-PICA common trunk. Single cases of arterial triplication or fenestration have also been documented. Specifically, in relation to HFS, AICA variants that compress the facial nerve at its root entry/exit zone include parabola-shaped loops, dominant segments proximal to the REZ, and anchor-shaped bifurcations impacting the nerve’s cisternal portion.

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Usefulness of Subtraction of 3D T2WI-DRIVE from Contrast-Enhanced 3D T1WI: Preoperative Evaluations of the Neurovascular Anatomy of Patients with Neurovascular Compression Syndrome

Cited by 9 publications

References 27 publications

Acute presentations of intradural lipomas: case reports and a review of the literature

Acute presentations of intradural lipomas: case reports and a review of the literature

Reliability of MRI for predicting characteristics of neurovascular conflicts in trigeminal neuralgia: implications for surgical decision making

The Anterior Inferior Cerebral Artery Variability in the Context of Neurovascular Compression Syndromes: A Narrative Review

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