Skip to main content
SpringerLink
Log in

Is preoperative high-resolution magnetic resonance imaging accurate in predicting neurovascular compression in patients with trigeminal neuralgia?

A single-blind study

  • Original Article
  • Published:
Neurosurgical Review Aims and scope Submit manuscript

Abstract

High-resolution magnetic resonance imaging (HR-MRI) using three-dimensional fast imaging employing steady-state acquisition (3D-FIESTA) and double-dose contrast-enhanced three-dimensional fast spoiled gradient echo (3D-FSPGR) sequences is considered to be a useful tool in detecting neurovascular compression in patients with trigeminal neuralgia. The purpose of this study was to analyze the accuracy and preoperative diagnostic value of these high-resolution imaging techniques in patients with trigeminal neuralgia, in a single-blind study. The preoperative MRI images of 21 consecutive patients were matched to one neuroradiologist, who was blind as to which side exhibited the symptoms. The images and post-processing multiplanar reconstructions were compared with the video-documented operative observations. HR-MRI using only 3D-FSPGR sequences demonstrated neurovascular compression in accordance with the intraoperative finding in 11 patients (52.4%). In the subgroup where, additionally, 3D-FIESTA sequences were available, neurovascular compression was in accordance with the intraoperative finding in 71.4% (n=7). High-resolution magnetic resonance imaging using double-dose contrast-enhanced 3D-FSPGR and 3D-FIESTA sequences is currently not sufficient enough to make an accurate prediction of neurovascular compression in a single-blind setting. These 3D imaging techniques currently provide only limited information, and one should consider their use carefully when identifying patients with trigeminal neuralgia from operation until image quality is improved by superior image resolution that can accurately discriminate vessels surrounding the trigeminal root entry zone.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2a–c
Fig. 3a–c

Similar content being viewed by others

References

  1. Akimoto H, Nagaoka T, Nariai T, Takada Y, Ohno K, Yoshino N (2002) Preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia by use of three-dimensional reconstruction from two types of high-resolution magnetic resonance imaging. Neurosurgery 51:956–961

    Article  PubMed  Google Scholar 

  2. Barker FG, Jannetta PJ, Bissonette DJ, Larkins MV, Jho HD (1996) The long-term outcome of microvascular decompression for trigeminal neuralgia. N Engl J Med 334:1077–1083

    PubMed  Google Scholar 

  3. Chang JW, Chang JH, Park YG, Chung SS (2000) Microvascular decompression in trigeminal neuralgia: a correlation of three-dimensional time-of-flight magnetic resonance angiography and surgical findings. Stereotact Funct Neurosurg 74:167–174

    CAS  PubMed  Google Scholar 

  4. Hastreiter P, Naraghi R, Tomandl B, Bonk A, Fahlbusch R (2003) Analysis and 3-dimensional visualization of neurovascular compression syndromes. Acad Radiol 10:1369–1379

    PubMed  Google Scholar 

  5. Heiss SG, Shifrin RY, Sommer FG (2000) Contrast-enhanced three-dimensional fast spoiled gradient-echo renal MR imaging: evaluation of vascular and nonvascular disease. Radiographics 20:1341–1352

    CAS  PubMed  Google Scholar 

  6. Jannetta PJ (1967) Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. J Neurosurg 26 [Suppl]:62

    Google Scholar 

  7. Jannetta PJ, Robbins LJ (1980) Trigeminal neuropathy—new observations. Neurosurgery 7:347–351

    Google Scholar 

  8. Kakizawa Y, Hongo K, Takasawa H, Miyairi Y, Sato A, Tanaka Y, et al (2003) “Real” three-dimensional constructive interference in steady-state imaging to discern microneurosurgical anatomy—technical note. J Neurosurg 98:625–630

    Google Scholar 

  9. McLaughlin MR, Jannetta PJ, Clyde BL, Subach BR, Comey CH, Resnick DK (1999) Microvascular decompression of cranial nerves: lessons learned after 4400 operations. J Neurosurg 90:1–8

    Google Scholar 

  10. Meaney JF, Eldridge PR, Dunn LT, Nixon TE, Whitehouse GH, Miles JB (1995) Demonstration of neurovascular compression in trigeminal neuralgia with magnetic resonance imaging. Comparison with surgical findings in 52 consecutive operative cases. J Neurosurg 83:799–805

    Google Scholar 

  11. Patel NK, Aquilina K, Clarke Y, Renowden SA, Coakham HB (2003) How accurate is magnetic resonance angiography in predicting neurovascular compression in patients with trigeminal neuralgia? A prospective, single-blinded comparative study. Br J Neurosurg 17:60–64

    CAS  PubMed  Google Scholar 

  12. Rothman KJ, Monson RR (1973) Survival in trigeminal neuralgia. J Chronic Dis 26:303–309

    CAS  PubMed  Google Scholar 

  13. Rovit RL (1992) Trigeminal neuralgia. Compr Ther 18:17–21

    CAS  Google Scholar 

  14. Wilkins RH (1979) Tic douloureux. N C Dent J 62:27–29; 31

    CAS  PubMed  Google Scholar 

  15. Yoshino N, Akimoto H, Yamada I, Nagaoka T, Tetsumura A, Kurabayashi T, et al (2003) Trigeminal neuralgia: evaluation of neuralgic manifestation and site of neurovascular compression with 3D CISS MR imaging and MR angiography. Radiology 228:539–545

    PubMed  Google Scholar 

  16. Yousry I, Moriggl B, Holtmannspoetter M, Schmid UD, Naidich TP, Yousry TA (2004) Detailed anatomy of the motor and sensory roots of the trigeminal nerve and their neurovascular relationships: a magnetic resonance imaging study. J Neurosurg 101:427–434

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Philipps University, Medical Center, Baldinger Strasse, 35043, Marburg, Germany

    Ludwig Benes, Ulrich Sure, Wuttipong Tirakotai, Boris Krischek & Helmut Bertalanffy

  2. Department of Neuroradiology, Philipps University, Medical Center, Marburg, Germany

    Kiyoshi Shiratori & Mariana Gurschi

Authors
  1. Ludwig Benes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kiyoshi Shiratori
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mariana Gurschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ulrich Sure
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wuttipong Tirakotai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Boris Krischek
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Helmut Bertalanffy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ludwig Benes.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Benes, L., Shiratori, K., Gurschi, M. et al. Is preoperative high-resolution magnetic resonance imaging accurate in predicting neurovascular compression in patients with trigeminal neuralgia?. Neurosurg Rev 28, 131–136 (2005). https://doi.org/10.1007/s10143-004-0372-3

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10143-004-0372-3

Keywords

Search

Navigation