| Objective:To quantify the surface(S)of neurovascular contact(NVC)in patients wth primary trigeminal neuralgia(PTN)by means of radiomics,and calculate the pressure F(S*MAP,F)of neurovascular compression(NVC)in combination with the mean arterial pressure(MAP)of PTN patients,and analyze the relationship between S,MAP and F and the incidence of PTN,The screening function of PTN diagnosis was measured.Methods:The demographic characteristics and MRI:balanced turbine field echo(BTFE)and enhanced T1 high-resolution isotropic volume excitation(E-THRIVE)data of46 patients with PTN were retrospectively analyzed A total of 54 patients with the neurovascular model were constructed by post-processing the MRI data using 3D Slicer software,including 40 patients with affected lateral with vascular compression(AL)nerve and 14 patients with healthy lateral with vascular compression(HL)nerve.S was calculated by means ofr adiomics.The relationship between demographic characteristics(sex,age,course of the disease,side of the disease,etc.),S,MAP,area and mean arterial pressure product(S*MAP,F)and PTN was statistically analyzed.Logistic regression was used to analyze the relationship between PTN disease-related variables and PTN disease(that is,the healthy side vs the affected side),and then the differences between the demographic characteristics,S,MAP,and the area and mean arterial pressure product(S*MAP,F)ofthe healthy side and the affected side were compared through t-test.Finally,the effectiveness of demographic characteristics,S,MAP,and F in screening PTN disease was evaluated through receiver operating characteristic(ROC)curve analysis.Results:①The S ofAL(25.50±13.95,mm~2)was greater than that of HL(14.78±7.69,mm~2,p<0.05).②The MAP of AL(92.92±10.74,mmHg)and HL(93.78±15.43,mmHg)had no statistical difference between the groups(p>0.05).③F of AL(2369.94±1321.61,mmHg*mm~2)is greater than F of HL(1335.61±667.84,mmHg*mm~2)(p<0.05).④The S produced by vertebral artery compression(39.41±20.85,mm~2)was greater than that of the superior cerebellar artery(20.24±10.09,mm~2)(P<0.05).⑤S(29.20±17.31,mm~2)on the male side was larger than that on the female side(18.91±8.72,mm~2)(P<0.05).⑥Univariate analysis showed that S and F were the related factors of PTN(p<0.05),while age,sex,course of the disease,side of the disease,type of responsible vessel,etc.had no significant correlation with PTN(p>0.05).Multivariate logistic regression showed that F was significantly associated with PTN(p<0.05).⑦The ROC curve showed that the area under the curve and 95%confidence interval of S and F were 0.75(0.605-0.890)and 0.76(0.62-0.90),respectively.The optimal cutoff point of S was 25.34 mm~2,the sensitivity was 42.5%,and the specificity was 100%.The optimal cutoff point of F was 1672.98 mmHg*mm~2,the sensitivity was 67.5%,and the specificity was 78.6%.Conclusion:①This study provides a method for measuring the S of NVC in PTN patients through the application of radiomics.②The relevant factors affecting the pathogenesis of NVC were explored and the existence of anomalous hydrodynamic relationships between NVC was explained.F was obtained by accurately quantifying S combined with MAP,and an association between F and PTN pathogenesis was found.③S and F have clinical significance in the diagnosis and screening of PTN and establish the screening model of PTN.④It provides a new idea for the pathogenesis of PTN and the choice of treatment methods and also expands the application of radiomics in neurosurgery. |
