The Value Of Magnetic Resonance Imaging3D-TOF And3D-FIESTA For Primary Trigeminal Neuralgia

Objective:This article focuses on finding arteries responsible for trigeminal neuralgia, discussing the relationships between the responsible arteries and facial nerves, and thus identifying the main types of the responsible arteries by analysis of3D-TOF and3D-FIESTA sequence in3.0T MR.Methods:The3D-TOF and3D-FIESTA sequence in3.0T MR for105trigeminal neuralgia(TN) patients and80non-trigeminal neuralgia patients were retrospectively analysed. The affected sides of trigeminal neuralgia patients consisted the case group, and the unaffected sides and both sides of non-trigeminal neuralgia patients consisted the control group. The MRI images of trigeminal nerve root were studied. The relationship between trigeminal neuralgia root and its surrounding vessels, the composition of responsible arteries and the probable responsible types with high occurrences were investigated. The following five types of relationship were classified: type1-no surrouding artery, type2-far away surrouding artery, type3-close surrouding artery, type4-contacted surrouding artery and type5-compressive surrouding artery. Type1,2and3were regarded as negative and type4and5were regarded as positive.Results:MRI images of all the370sides showed clear trigeminal nerve root and surrounding structures. Among the106sides (1patients with spasm on both sides) in the case group,27sides were classified into type5(25.5%) and53sides were classified into type4(50.0%), while among the104healthy sides of trigeminal neuralgia patients, no sides were classified into type5and16sides were classified into type4(15.4%). For the160sides of non-trigeminal neuralgia patients, no sides were classified into type5and26sides were classified into type4(16.3%). There is no statistic significant difference between control group and non-trigeminal neuralgia group regarding artery composition, but the difference between case group and control group (unaffected sides and both sides of non-trigeminal neuralgia patients) was statistically significant (P<0.05). SCA accounted71.25%of the responsible arteries; AICA accounted20.0%, BA accounted2.5%, two arteries accounted5.0%,and vein accounted the left1.25%.Conclusion:The3D-TOF and3D-FIESTA sequence of MRI provide us a better view of trigeminal nerve and its surrounding sturcture, especially the correlation between artery and trigeminal nerve. Clinical use of this sequence help to confirm the pathogen of trigeminal neuralgia, make decision to decompressive operation and evaluate the prognosis.