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Erschienen in:
23.03.2022 | Magnetic Resonance
Significance of different offending vessels and development of a potential screening tool for trigeminal neuralgia
Erschienen in: European Radiology | Ausgabe 9/2022
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Objectives
This study was performed amongst trigeminal neuralgia (TN) patients with neurovascular contact (NVC) to 1) investigate the association of the demographic and radiologic factors/variables with TN occurrence, and 2) develop a screening tool for TN/TN-affected nerves based on the factors/variables associated with it.
Methods
Eighty-five TN patients were recruited, and 121 trigeminal nerves with NVC were derived from them. Based on MRI sequences, including balanced turbo field echo and enhanced T1 high-resolution isotropic volume excitation, radiologic factors/variables for each nerve, from the offending vessel to the presence of nerve displacement, were identified by a neuroradiologist and a neurosurgeon. Demographic and clinical data were obtained from clinical notes. Logistic regression was performed to assess the association of the factors/variables with TN occurrence (i.e., affected vs. unaffected nerves).
Results
Three factors/variables were significantly (p < 0.05) associated with TN occurrence amongst patients with NVC: nerve laterality, vertebral artery (VA) involvement, and the presence of nerve displacement. The nerves with VA involvement, those on the right side, and those with nerve displacement exhibited a significantly higher likelihood/odd of being affected by TN, compared to those without VA involvement, those on the left side, and those without nerve displacement, respectively. Based on these factors/variables, a screening tool/nomogram with acceptable accuracy was established (C-statistic/AUC = 0.80).
Conclusions
This study revealed an association of the three radiologic factors/variables with TN occurrence. A screening tool for TN/TN-affected nerves was established based on them. The findings may lay a foundation for an improvement of the diagnosis and clinical management of TN.
Key Points
• VA involvement and nerve displacement could be identified using MRI, and are significantly associated with TN occurrence.
• A potential objective screening tool/nomogram for TN/TN-affected nerves could be established based on the three radiologic factors/variables: VA involvement, the presence of nerve displacement, and nerve laterality.
• The screening accuracy of the tool/nomogram is acceptable as the C-statistic is 0.80.