Clinical Application Of DTI In Delayed Relief And Recurrence Of Trigeminal Neuralgia

Objective: The main manifestation of trigeminal neuralgia(TN)is paroxysmal sharp burning,knife cutting,needle-like or electric shock-like pain in the trigeminal nerve area,in recent years,diffusion tensor imaging(DTI)is water molecules of the sensitive,has been used to study the microstructural changes of trigeminal neuralgia trigeminal nerve,however,the Association of DTI markers with delayed remission and recurrence after trigeminal neuralgia MVD surgery has never been reported.The aim of this study was to investigate whether trigeminal nerve microstructural changes were associated with delayed remission and recurrence after trigeminal neuralgia MVD surgery,according to the parameters of DTI,the pathogenesis of TN,the delayed remission after MVD and the mechanism of pain recurrence were further explained and discussed.Methods: The clinical data of the 45 trigeminal neuralgia patients who underwent trigeminal nerve microvascular decompressionfrom 2020 to 2022 in the Department of Neurosurgery of the First Affiliated Hospital of China Medical University were analyzed retrospectively,the correlation between the degree of demyelinating injury of the trigeminal nerve before operation and the delayed remission and recurrence of the trigeminal neuralgia was analyzed.Results: In 45 patients,the FA value of the contralateral side(mean FA ± SD,0.46 ±0.03)was higher than that of the affected side(mean FA ± SD,0.40.03)(P < 0.05).So we can conclude that the degree of decline in FA in the affected side is of great significance in the diagnosis of trigeminal neuralgia.Six months after surgery,these45 patients were reexamined for DTI,the results showed that the FA value of the affected side(0.45 ± 0.04)was significantly higher than that of the preoperative side(0.40.03)at 6 months after operation(P < 0.05),the mean FA ± SD(0.46 ± 0.04)was significantly higher than the mean FA ± SD(0.40.03)(P < 0.05).This set of data indicates that there is an overall tendency for patients to recover from impaired trigeminal nerve after MVD.Conclusion: The introduction of DTI has provided us with a better understanding of trigeminal neuralgia,allowing us to be more accurate in the preoperative diagnosis and treatment of trigeminal neuralgia,and trigeminal neuralgia patients have a much more intuitive measure of recovery after surgery.It’s a technological innovation that allows us to treat trigeminal neuralgia better in the clinic.