| Objective:To explore the relationship between the volume and cross-sectional area of the trigeminal nerve cistern segment and the diagnosis of trigeminal neuralgia,and to provide a reference for the clinical diagnosis and treatment of trigeminal neuralgia,in order to achieve the diagnosis of trigeminal neuralgia by preoperative imaging and to evaluate the outcomes of microvascular decompression.Methods:We retrospective analyzed the 59 patients who were diagnosed of primary trigeminal neuralgia and microvascular decompression was performed(39 males,20 females,mean age 57.37,range from 30 to 77 years)in the Neurosurgery Department of the Afflicted Hospital of Qingdao University.We selected 25 individuals who were without trigeminal neuralgia(8 males,17 females,mean age 52.52,age range from 35 to 67 years old)in the same period as the control group.The patients were performed axial T1 WI,T2WI,and FLAIR sequence with 3.0T MRI and exclude secondary Trigeminal neuralgia such as: cerebella tumor,aneurysm,infarction and multiple sclerosis.The MRI 3D-FIESTA and 3D-TOF sequences were examined with the pons as the center.When the examination was over,the 3D-FIESTA sequence imagines were transfered into the ADW4.5 workstation provided by GE,the use of the reformat software and the aberrant position images were reconstructed.The transverse axis images of the bilateral trigeminal nerve segments were measured on the MIPAV software.The trigeminal cross-sectional area was measured with the coronal images reconstructed at about 5 mm along the trigeminal nerve of root entry zone to pons.Review the patient cases and surgical records,detailed responsibility for the type of blood vessels,the responsibility of vascular compression nerve location,the degree of neurovascular compression,the patients were performed microvascular decompression treatment.SPSS 21.0 for window was used to analyze the data.It is a significant statistically difference when P <0.05.Results:The mean volume of the trigeminal nerve on the ipsilateral TN(63.25 ± 14.52mm3)was significantly smaller(P <0.05)than those on the contralateral TN(74.37 ± 16.48mm3)and the control group(73.17±13.76 mm3).There was no significant difference between the mean volume of contralateral TN and the trigeminal nerve volume(P>0.05)in the control group.Similar,the mean cross sectional area of the trigeminal nerve on the ipsilateral TN(3.79±1.09mm2)was significantly smaller(P <0.05)than those on the contralateral PTN(4.65±1.31mm2)and the control group(4.90±1.09mm2).There were no statistical significance correlations between reduction of symptomatic and asymptomatic lateral in volume and cross-sectional area of the PTN patients in gender,age,symptom side,duration time before microvascular decompression.There was no significant difference in the mean volume difference between the grade ?(obvious indentation)and the grade ?(shift / twist).The difference of the cross sectional area of the ? degree and ?degree was significantly greater than that of the?degree(P<0.05).The reduction of cross-sectional area of cured PTN(12.12%±7.50%)by microvascular decompression was significantly greater than that of patients with poor outcome(7.55%±5.95%,P <0.05).Trigeminal nerve volume,the same similar results,but the P value is greater than 0.05.Conclusion: 1.There was a statistically significant difference in the volume,cross-sectional area between the on the ipsilateral,contralateral PTN and the control group.This difference was related to the diagnosis of trigeminal neuralgia.2.There was a significant difference between the symptomatic and non-symptomatic volume and cross-sectional area of the trigeminal neuralgia and the type of vascular vessel,and the degree of vascular compression was statistically significant.3.Microvascular decompression of patients with complete cure of trigeminal nerve cross-sectional area and poor treatment group were significantly different.Significance: This study indicates that high-resolution MRI 3D-TOF and FIESTA can clearly show trigeminal atrophy.The data of this study trigeminal atrophy and compression and surgical prognosis was significantly related to help predict the long-term prognosis of microvascular decompression. |
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