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Recent Advances and Future Perspective in MRI Technique for the Trigeminal Neuralgia

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Trigeminal Neuralgia

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Abstract

Trigeminal neuralgia is a neurological disorder characterized by recurrent, paroxysmal, short-lasting, lancinating facial pain restricted to the unilateral trigeminal territory, and usually triggered by innoxious stimuli. Trigeminal neuralgia can be divided into classical, secondary, and idiopathic. Trigeminal neuralgia is classified as idiopathic when any diagnostic tests fail to reveal a lesion or disease that can cause trigeminal neuralgia [1]. Neurovascular compression with morphological change of the trigeminal nerve on MRI or during surgery is essential to classify trigeminal neuralgia as classical. Secondary trigeminal neuralgia is categorized when trigeminal neuralgia is caused by an underlying disease such as tumor in cerebellopontine angle/Meckel’s cave or multiple sclerosis [1]. Although the diagnosis of trigeminal neuralgia is made clinically, the combination of high-resolution, 3D T2-weighted images, post-contrast 3D T1-weighted images, and TOF-MRA with 3D reconstruction have provided us reliable information about the presence and severity of neurovascular compression in classical trigeminal neuralgia [2, 3]. It also helps us to exclude other causes of trigeminal neuralgia such as infectious, inflammatory, demyelinating disease, or tumor. Moreover, recent advances in structural and functional imaging enable us to elucidate the pathomechanism of trigeminal neuralgia [4]. In this chapter, we review recent trends in the MR techniques for detecting neurovascular conflict between the trigeminal nerve and vascular structures in trigeminal neuralgia, which includes MR cisternography and post-contrast 3D T1-weighted imaging. We also provide clinical application of MR techniques such as high-resolution, T1-weighted imaging for brain morphometry, diffusion tensor imaging, and resting-state functional MRI to investigate structural and functional alteration in the central nervous system in trigeminal neuralgia. To acquire the previously mentioned, 3D, high-resolution, and various MR images within the clinically acceptable scan time, fast imaging techniques are inevitable. Fast imaging techniques such as parallel imaging, compressed sensing, or modified K-space sampling are briefly reviewed in advance. Lastly, we briefly introduce the clinical application of 7.0 T MRI in trigeminal neuralgia.

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  1. Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea

    Jin Woo Choi & Chung Hwan Kang

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  1. Jin Woo Choi
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Correspondence to Jin Woo Choi .

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  1. Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea (Republic of)

    Kwan Park

  2. Department of Neurosurgery, Konkuk University Medical Center, Seoul, Korea (Republic of)

    Kyung Rae Cho

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Choi, J.W., Kang, C.H. (2023). Recent Advances and Future Perspective in MRI Technique for the Trigeminal Neuralgia. In: Park, K., Cho, K.R. (eds) Trigeminal Neuralgia. Springer, Singapore. https://doi.org/10.1007/978-981-19-9171-4_7

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