Sensitivity of magnetic resonance tomographic angiography for detecting the degree of neurovascular compression in trige
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ORIGINAL ARTICLE
Sensitivity of magnetic resonance tomographic angiography for detecting the degree of neurovascular compression in trigeminal neuralgia Yun-bo Hao 1 & Wei-jie Zhang 1 & Min-jie Chen 1 & Ying Chai 1 & Wen-hao Zhang 1 & Wen-bin Wei 1 Received: 7 November 2019 / Accepted: 13 April 2020 # The Author(s) 2020
Abstract Purpose Neurovascular compression (NVC) is hypothesized to be the main pathogenic factor of trigeminal neuralgia (TN). Microvascular decompression (MVD) has become a popular surgery for TN, and the success rate depends on the degree of NVC. As the routine examination before MVD, magnetic resonance tomographic angiography (MRTA) shows high sensitivity for detecting NVC. However, there are no reports on the sensitivity of MRTA for assessing the degree of NVC. Methods This study aimed to evaluate the sensitivity of MRTA for determining the degree of NVC by comparing preoperative MRTA and intraoperative endoscopy findings. A total of 480 patients who suffered from TN and underwent MVD were included. Their preoperative MRTA and intraoperative endoscopy findings were reviewed. The kappa test was used to identify similarities between the MRTA and endoscopy findings. Results The degree of NVC on preoperative MRTA was similar to that on endoscopy (kappa = 0.770). The number of offending vessels according to preoperative MRTA was coincident with that according to endoscopy (kappa = 0.722). Conclusion MRTA had high sensitivity for detecting not only the presence of NVC but also the degree of NVC. Keywords Magnetic resonance tomographic angiography . Microvascular decompression . Endoscope . Trigeminal neuralgia
Abbreviations NVC Neurovascular compression TN Trigeminal neuralgia MVD Microvascular decompression
* Wei-jie Zhang [email protected] * Min-jie Chen [email protected] Yun-bo Hao [email protected] Ying Chai [email protected] Wen-hao Zhang [email protected] Wen-bin Wei [email protected] 1
Department of Oral and Maxillofacial Surgery, College of Stomatology, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
MRTA CPA
Magnetic resonance tomographic angiography Cerebellopontine angle
Trigeminal neuralgia (TN) is one of the most common facial pain disorders. Vascular compression is a widely acknowledged theory for the pathogenesis of TN. Neurovascular compression (NVC) was first reported by Gardner and Miklos [1] and is defined as direct contact between vessels and nerves. Microvascular decompression (MVD), which is now the standard surgery for TN, is based on the theory of NVC [2]. The surgery can efficiently and safely cure TN and reduce the possibility of facial numbness [3]. The success rate of MVD depends on the correct clinical indications and the preoperative radiological examination of NVC. Among all imaging modalities, magnetic resonance tomographic angiography (MRTA) has been accepted as the conventional radiological evaluation to perform before MVD. Commonly, compression by vessels or tumors occurs in the cerebellopontine angl
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