IMR Press / JIN / Volume 21 / Issue 6 / DOI: 10.31083/j.jin2106169
Open Access Original Research
A Combination of 3D TOF MRA and FIESTA Predicts Surgery-Needed Primary Trigeminal Neuralgia and Specific Offending Vessels
Show Less
1 Department of Diagnostic Radiology, Huzhou Central Hospital & Affiliated Central Hospital, HuZhou University, 313099 Huzhou, Zhejiang, China
2 Department of Diagnostic Radiology, Shanghai Six People Hospital, 200233 Shanghai, China
3 Department of Diagnostic Radiology, Sir Run Run Shaw Hospital, affiliated with the Zhejiang University School of Medicine, 310020 Hangzhou, Zhejiang, China
*Correspondence: (Jian Shen)
These authors contributed equally.
Academic Editors: Nicola Montemurro, Andrea Stoccoro and Giovanni Grasso
J. Integr. Neurosci. 2022, 21(6), 169;
Submitted: 23 May 2022 | Revised: 15 June 2022 | Accepted: 21 June 2022 | Published: 26 October 2022
(This article belongs to the Special Issue New Technologies in Neuroscience and Neurosurgery)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: To investigate the predictive accuracy of three-dimension (3D) time-of-flight (TOF) MR angiography (MRA) and 3D Fast Imaging Employing Steady-state Acquisition (FIESTA) techniques in assessing neurovascular compression (NVC) with specific vessels in patients with primary trigeminal neuralgia (TN). Methods: Patients with single-site primary TN undergoing microvascular decompression (MVD) were retrospectively recruited. All patients had available preoperative magnetic resonance imaging (MRI) scans. A quantitative NVC scoring system was applied to assess the severity of NVC on MRI. The radiological findings were correlated with the intraoperative result to determine the diagnostic accuracy of MRI techniques. Besides, the radiological indicator of MVD was determined. Results: Seventy-three TN patients were recruited. Thirty-three patient had bilateral NVC but with unilateral neuralgia. The average NVC score of the asymptomatic side was significantly lower than that of the symptomatic side (1.6 vs. 6.7; p < 0.001). A cut-off value of NVC >4 was determined as a radiological indicator of MVD with sensitivity and specificity of 82.2% and 98.6%, respectively Area Under Curve (AUC = 0.97; p < 0.001). Approximately 90% of symptomatic patients had the distance to REZ 3 mm. 68.5% of patients had a single conflicting vessel, and superior cerebellar artery (SCA) was the predominate vessel (46.6%). The sensitivity and specificity of MRI to detect NVC were 95.8% and 100%, respectively. Regarding each vessel, the cohen’s kappa statistic (K) was 0.632 overall. Conclusions: 3D TOF MRA and FIESTA show an overall good ability to predict specific offending vessels. NVC score >4 is identified to predict TN, suggestive of subsequent surgical treatment.

trigeminal neuralgia
neurovascular compression
microvascular decompression
2018GYB56/Science and Technology Bureau Program of Huzhou
Fig. 1.
Back to top