Preoperative evaluation of neurovascular relationship by using contrast-enhanced and unenhanced 3D time-of-flight MR angiography in patients with trigeminal neuralgia

Abstract

Contrast-enhanced 3D TOF MR angiography is useful in the detection of vascular contact with the trigeminal nerve in patients with TN, and this MR imaging in combination with unenhanced MR angiography could help in the identification of the nature of the responsible vessels.

Diagnostic value of 3D time-of-flight MRA in trigeminal neuralgia

“…The present study was conducted in TN patients confirmed by diagnostic criteria from the European Federation of Neurological Societies, or from the Quality Standards Subcommittee of the American Academy of Neurology [39]. Consistent with our results, Zhou et al also observed the high diagnostic performance of 3D-TOF-MRA in identifying causative vessels and trigeminal nerve compression degree in TN patients and concluded it can provide excellent diagnostic value in clinical therapy for TN patients [7].…”

“…However, 3D-TOF-MRA is still an emerging technique and flow artifacts and longer image acquisition times are inherent disadvantages [14,18]. Several previous studies have reported consistently high diagnostic performance of 3D-TOF-MRA in TN patients [8,19], however, other studies contradict these findings [7,16]. Therefore, the present meta-analysis investigated the diagnostic potential of 3D-TOF-MRA in the TN setting.…”

“…Studies have also shown that other rare conditions such as infarcts or angiomas in the pons or medulla or infiltration of the nerve root increases TN risk [6]. Previous studies have found that preoperative evaluation of the relationship between clinical symptoms and neurovascular involvement can significantly improve surgical planning and the outcomes of microvascular decompression but conventional imaging techniques are unhelpful for providing an accurate preoperative diagnosis [7]. Recently, 3D time-of-flight magnetic resonance angiography (3D-TOF-MRA) has attracted significant attention as an imaging technique with the potential to improve visualization of neurovascular relationships [8,9] 3D-TOF-MRA is a novel and non-invasive angiography technique for vascular studies, frequently used for neuroimaging within the head and brain [10].…”

“…In clinical practice, 3D-TOF-MRA is effective for TN diagnosis, providing improved visualization of the relationship between the trigeminal nerve and vessels [15], including the site of compression [16]. Compared with conventional imaging techniques, 3D-TOF-MRA offers better blood-to-background contrast and higher spatial resolution and it is an inexpensive, sensitive, safe and accurate imaging technique [7,17]. However, 3D-TOF-MRA is still an emerging technique and flow artifacts and longer image acquisition times are inherent disadvantages [14,18].…”

Preoperative detection of the neurovascular relationship in trigeminal neuralgia using three-dimensional fast imaging employing steady-state acquisition (FIESTA) and magnetic resonance angiography (MRA)

“…Our results show that the combination of 3D FIESTA imaging and 3D TOF MRA can be used to differentiate arterial and venous vasculature, which has also been shown in previous studies. 12,13,18,23,25 However, methodology in these studies varied. In the previous studies (including our own previous studies), 3D TOF MRA and contrast-enhanced T1-weighted 23 or spoiled gradient-recalled sequences 12,13,18,25 have been used to identify arterial or venous structures.…”