Oblique sagittal magnetic resonance imaging visualizing vascular compression of the trigeminal or facial nerve

Abstract

An oblique sagittal magnetic resonance (MR) imaging method was developed to provide better visualization of vascular compression of nerves. The MR images of 12 patients with trigeminal neuralgia and 24 with hemifacial spasm were analyzed. The oblique sagittal views were obtained along the nerve identified by the axial view at an angle of 105 degrees between the line along the dorsal brain stem and the line along the margin of the pontomedullary junction (in patients with hemifacial spasm) or by the midsagittal view through the midpons (in patients with trigeminal neuralgia). The T1- and T2-weighted, proton-density, and/or gradient-echo MR images were evaluated to optimize imaging conditions. The oblique sagittal gradient-echo MR image most clearly visualized vascular compression of the nerves as high-intensity lines in six patients with trigeminal neuralgia, which was confirmed intraoperatively in four. Fifteen (75%) of 20 oblique sagittal gradient-echo MR images demonstrated vascular compression of the facial nerves in patients with hemifacial spasm; 12 of these were confirmed intraoperatively. The control study used 15 oblique sagittal gradient-echo MR images of nonaffected contralateral and normal sites. Four false-positive findings were found. Oblique sagittal gradient-echo MR images are a useful planning aid, allowing differential diagnosis prior to microvascular decompression in trigeminal neuralgia and hemifacial spasm.

The potent role of increased sympathetic tone in pathogenesis of essential hypertension with neurovascular compression

“…Recently, MRT accurately and non-invasively assesses the neurovascular relations and neurovascular compression in the posterior fossa. 6,7 Clinical studies using MRT have suggested that the neurovascular compression may cause hypertension has been reported. 8,9,13 The frequency of neurovascular compression of the RVLM has been found to be high in German, 9 Italian 14 and Japanese 8,9 patients with essential hypertension.…”

“…3 Neurovascular compression of the RVLM has been proposed as a cause of essential hypertension in a surgical case, 4 an angiographic study, 5 and more recent magnetic resonance tomography (MRT) studies. [6][7][8][9] Nagashi et al 10 have suggested that a large portion of cases of essential hypertension can be explained by neurovascular compression. However, there has been no clinical study of the mechanism of the neurovascular compression-induced increase in blood pressure.…”

Three-Dimensional Short-Range MR Angiography and Multiplanar Reconstruction Images in the Evaluation of Neurovascular Compression in Hemifacial Spasm

“…Du et al (1) reported that the relationship between nerves and vessels is in some cases difficult to evaluate by means of transversly orientated 3D FISP imaging; the use of the MPR algorithm or oblique sagittal orientation might well improve the precision of evaluation (10,11). Our 3D MPR studies provided additional information such as the direction of compression and the course ofthe compressive vessel.…”

Brainstem compression syndrome caused by vertebrobasilar dolichoectasia: microvascular repositioning technique

“…The usefulness of neuradiological methods such as computed tomography and MRI are still controversial. MRI sensivity and specificity to diagnose VBD are unknown 15 . Some authors emphasized that good results depend on the correct MRI projection (oblique sagittal) and the appropriate gradient echo sequences.…”