| Visualization of Vascular Compression of the Trigeminal Nerve with High-Resolution 3-T MRI: A prospective study comparing pre-operative imaging analysis to surgical findings in 40 consecutive patients who underwent Micro-Vascular Decompression for Trigeminal Neuralgia. | |
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MedLine Citation:
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PMID: 21346659 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND:: High-resolution three-dimensional (3-D) Magnetic Resonance Imaging (MRI) has demonstrated its ability to predict fine trigeminal neurovascular anatomy. OBJECTIVE:: To addresses the predictive value of 3-Tesla (3-T) MRI in detecting and assessing features of Neurovascular Compression (NVC), particularly on the degree of compression exerted on the root, in patients who underwent Microvascular Decompression (MVD) for classic primary trigeminal neuralgia METHODS:: Included in this prospective study are 40 consecutive patients who underwent MVD for classic primary trigeminal neuralgia. All patients underwent a pre-operative 3-T-MRI with 3-D-T2-DRIVE, 3-D-TOF-MRA and 3-D-T1-Gadolinium (Gad) sequences in combination. An evaluation by two independent observers was performed and compared with the operative findings. RESULTS:: For prediction of NVC, image analysis corresponded with surgical findings in 39 cases. Among the 3 patients in whom image analysis did not show NVC, 2 did not have NVC at the time of intra-operative observation. MRI sensitivity was 97.4% (37/38) and specificity was 100% (2/2). The Kappa-coefficient (K) for predicting the offending vessel, its location and site of compression was 0.882, 0.813 and 0.942, respectively. Image analysis correctly defined the severity of the compression in 31 of the 37 cases. The K predicting the degree of compression was 0.813, 0.833 and 0.852, respectively, for Grades I (simple contact), II (distortion) and III (marked indentation). CONCLUSION:: 3-T-MRI using 3-D-T2-DRIVE in combination with 3-D-TOF-MRA and 3-D-T1-Gad sequences proved to be reliable in detecting NVC and in predicting the degree of root compression, the outcome being correlated with the latter. |
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Authors:
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Paulo Roberto Lacerda Leal; Marc Hermier; Miguel Angelo Souza; Gerardo Cristino-Filho; Jean Claude Froment; Marc Sindou |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-2-22 |
Journal Detail:
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Title: Neurosurgery Volume: - ISSN: 1524-4040 ISO Abbreviation: - Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-2-24 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1Department of Neurosurgery, University Claude-Bernard of Lyon, Lyon, France; 2Department of Neuroradiology, University Claude-Bernard of Lyon, Lyon, France; 3Department of Clinical Medicine of the Faculty of Medicine of Fortaleza, Federal University of Ceará, Fortaleza, Brazil; 4Department of Neurosurgery of the Faculty of Medicine of Sobral, Federal University of Ceará, Sobral, Brazil. |
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