Trigeminal neuralgia: assessment with T2 VISTA and FLAIR VISTA fusion imaging.

OBJECTIVE

To evaluate the neurovascular compression (NVC) in patients with trigeminal neuralgia (TN) using T2 VISTA and FLAIR VISTA fusion imaging.

METHODS

Sixty-six consecutive patients with TN who underwent MR imaging at 3-T between April 2008 and December 2010 were retrospectively reviewed. Multiplanar reconstructions (MPR) of T2 VISTA and FLAIR VISTA fusion imaging were used for image interpretation. The frequency of vascular contact, the segment of compression and the type of vessel were compared between the ipsilateral symptomatic side and the contralateral asymptomatic side.

RESULTS

The frequency of vascular contact on the ipsilateral side and the contralateral side were 95.5% (63/66) and 74.2% (49/66), respectively. The frequency of indentation on the ipsilateral side and contralateral side were 74.2% (49/66) and 21.2% (14/66), and showed a statistically significant difference (p < 0.05). The sensitivity, specificity and odds ratio were 77.8%, 71.4% and 10.7, respectively. There were no significant differences in the involved segment or type of vessel between the ipsilateral side and contralateral side.

CONCLUSION

MPR of T2 VISTA and FLAIR VISTA fusion imaging is useful in the detection of NVC in patients with TN. Vascular indentation can predict the presence of symptoms in patients with TN. Key Points •Fusion MRI with multiplanar reconstruction can detect neurovascular compression in patients with trigeminal neuralgia •Vascular indentation can predict the presence of symptoms in patients with trigeminal neuralgia •In patients with trigeminal neuralgia, neurovascular indentation is commoner on the symptomatic side.