JRM
Journal of Radiology in Medicine

Journal of Radiology in Medicine is an international journal that published original research and articles in all areas of radiology. Its publishes original research articles, review articles, case reports, editorial commentaries, letters to the editor, educational articles, and conference/meeting announcements.

eISSN: 3023-6487
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Original Article
The comparison of the efficacy of 3D fast spoiled gradient echo sequence and steady state free precession sequence in imaging vascular compression in patients with trigeminal neuralgia
Abstract
Aims: Trigeminal neuralgia is a condition characterized by sudden and intense pain in the face, affecting the fifth cranial nerve. While it can occur for various reasons, vascular compression is a well-known cause. Additionally, conditions such as tumors, arachnoid cysts, idiopathic inflammation, damage, or demyelination can result in trigeminal neuralgia, extending to the distal branches of the trigeminal nerve from the pons. We aimed to investigate the diagnostic efectiveness of post-contrast three-dimensional fast spoiled gradient echo images (3D-FSPGR) in addition to steady-state free precession (SSFP) images in the imaging of trigeminal neuralgia.
Methods: A total of 33 patients with a preliminary diagnosis of trigeminal neuralgia between May 2022 and October 2023 were investigated and five individuals were excluded. Among the remaining 28 patients, vascular compression was observed in only 14 patients. Trigeminal nerve thickness on both side, the distance between trigeminal nerve and superior cerebellar artery on both side, presence of vascular compression, level of the compression, presence or absence of displacement and atrophy were reported for each sequences. The findings and results were compared using independent sample T-test and paired T-test.
Results: The mean age of the patient group was calculated to be 56.29 ± 4.5, while for the control group, it was 52.07 ± 3.09. Trigeminal nerve thickness wasn’t different between patient with or without vascular compression (p=0.874 for right side on SSFP, p=0.804 for left side on SSFP, p=0.667 for right side on 3D-FSPGR and 0.769 for left side on 3D-FSPGR). In 10 patients, unilateral compression of the trigeminal nerve was observed, while in 4 patients, it was bilateral. In the right trigeminal nerve, vascular compression was observed in SSFP images in 5 cases in the transitional zone, 2 cases in the nerve root entry zone, and 1 case distally. In 3D-FSPGR images, it was interpreted as being in the transitional zone in 4 cases, in the NR entry zone in 3 cases, and distally in 1 case. On the other hand, for the left trigeminal nerve, vascular compression was observed in both SSFP and 3D FSGPR images in 5 cases in the nerve root entry zone, 3 cases in the distal zone, and 2 cases in the transitional zone.
Conclusion: Both SSFP and 3D-FSPGR images can provide comparable information regarding the spatial relationship between the trigeminal nerve and vascular structures. Contrast enhanced imaging allows us diferentiate the tumoral and infammatory demyelinating processes from vascular compression, we recommended to continue with SSFP images in cases where contrast enhanced 3D FSGPR images are inconclusive.

Keywords : Trigeminal neuralgia, three dimensional images, vascular compression

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1. Haller S, Etienne L, K&ouml;vari E, Varoquaux AD, Urbach H, Becker M. Imaging of neurovascular compression syndromes: trigeminal neuralgia, hemifacial spasm, vestibular paroxysmia, and glossopharyngeal neuralgia. <em>AJNR.</em> <em>Am J Neuroradiol</em>. 2016;37(8):1384-1392.
2. Anwar H, Ramya Krishna M, Sadiq S. et al. A study to evaluate neurovascular conflict of trigeminal nerve in trigeminal neuralgia patients with the help of 1.5T MR imaging. <em>Egypt J Radiol Nucl Med</em>. 2022;53(1):66.
3. Hughes MA, Frederickson AM, Branstetter BF, Zhu X, Sekula RF. MRI of the trigeminal nerve in patients with trigeminal neuralgia secondary to vascular compression. <em>AJR. Am J Roentgenol</em>. 2016;206(3):595-600.
4. Turk Boru U, Boluk C, Ozdemir A, Demirbas H, Taşdemir M, Gezer Karabacak T, Dumanlı, A. Cervical discopathy in idiopathic trigeminal neuralgia: more than coincidence? <em>Adv Spine J</em>. 2021;40(1):53-64.
5. Headache classification committee of the international headache society (IHS): the international classification of headache disorders, 3rd edition. Cephalalgia. 2018;38:1-211.
6. Cruccu G, Finnerup NB, Jensen TS, et al. Trigeminal neuralgia: new classification and diagnostic grading for practice and research. J Neurol. 2016;87(2):220-228.
7. Antonini G, Di Pasquale A, Cruccu G, et al. Magnetic resonance imaging contribution for diagnosing symptomatic neurovascular contact in classical trigeminal neuralgia: a blinded case-control study and meta-analysis. <em>Pain</em>. 2014;155(8):1464-1471.
8. Jannetta PJ. Arterial compression of the trigeminal nerve at the pons in patients with trigeminal neuralgia. <em>J Neurosurg</em>. 1967;26(1):159-162.
9. Miller J, Acar F, Hamilton B, Burchiel K. Preoperative visualization of neurovascular anatomy in trigeminal neuralgia. <em>J Neurosurg</em>. 2008; 108(3):477-482.
10. Dandy WE. Concerning the cause of trigeminal neuralgia. <em>Am J Surg</em>. 1934;24(2):447-455.
11. M&uuml;ller S, Khadhraoui E, Khanafer et al. Differentiation of arterial and venous neurovascular conflicts estimates the clinical outcome after microvascular decompression in trigeminal neuralgia. <em>BMC Neurol</em>. 2020;20(1):279.
12. Lemos L, Alegria C, Oliveira J, Machado A, Oliveira P, Almeida A. Pharmacological versus microvascular decompression approaches for the treatment of trigeminal neuralgia: clinical outcomes and direct costs. <em>J Pain Res</em>. 2011;4:233-244.
Article available in :
Volume 1, Issue 4, 2024
Page : 69-72
https://doi.org/10.51271/JRM-0018
Article Information
Received : 29 Eyl 2024
Accepted : 20 Eki 2024
Published : 30 Eki 2024
Corresponding Author :

Mustafa Hızal: Abant İzzet Baysal University, Faculty of Medicine, Department of Radiology, Bolu, Turkey

[email protected]
Citation : Hızal M, Buz Yaşar A. The comparison of the efficacy of 3D fast spoiled gradient echo sequence and steady state free precession sequence in imaging vascular compression in patients with trigeminal neuralgia. J Radiol Med. 2024;1(4):69-72.

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