Significance and value analysis of 3.0 T time-leaps magnetic resonance angiography for trigeminal microvascular decompression / 中国医师进修杂志

ABSTRACT

Objective:To analyze the clinical guidance value of 3.0 T three-dimensional time of fly magnetic resonance angiography (3D-TOF-MRA) in patients with trigeminal neuralgia (TN) who underwent microvascular decompression (MVD) treatment.Methods:The clinical and imaging data of 60 TN patients who underwent MVD treatment in Jinhua People′s Hospital from January 2019 to December 2019 were retrospectively analyzed. All patients underwent 3D-TOF-MRA examination before the surgery. The relationship and direction of the trigeminal neuralgia and surrounding blood vessels were observed, the responsible blood vessels that compressed the nerves before the surgery were determined, and vascular nerve compression (NVC) was clarified.Results:Among the 60 TN patients, pain symptoms of 52 patients (86.67%) completely disappeared after the surgery, and the pain symptoms of the remaining 8 patients (13.33%) were also significantly relieved. There was no statistically significant difference between 3D-TOF-MRA examination and MVD surgery in the judgment of the responsible vessel ( P>0.05). The positive rate of TN diagnosed by MVD surgery was 98.33% (59/60), and the positive rate of TN diagnosed by 3D-TOF-MRA was 91.67% (55/60), with no statistically significant difference ( P>0.05), and with highly consistency by Kappa test ( Kappa value=0.867). The area under the curve (AUC) of TN diagnosed by 3D-TOF-MRA through receiver operating characteristic (ROC) curve analysis was 0.730 (95% CI 0.526~0.934). The incidence of NVC diagnosed by 3D-TOF-MRA was 63.33%(38/60), and the incidence of NVC seen by MVD surgery was 61.67%(37/60). There was no statistically significant difference in the diagnosis of NVC between 3D-TOF-MRA and MVD surgery. ( P>0.05). Conclusions:The 3D-TOF-MRA examination can more accurately know the position, orientation, shape and compression degree of the responsible blood vessel in TN patients, which has important guiding value for the clinical diagnosis of TN and preoperative evaluation of MVD.