Unal Tugrul Cem, Unal Omer Faruk, Barlas Orhan, Hepgul Kemal, Ali Achmet, Aydoseli Aydin, Aras Yavuz, Sabanci Pulat Akin, Sencer Altay, Izgi Nail
Department of Neurosurgery, Tunceli State Hospital, Tunceli, Turkey.
Department of Neurosurgery, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
World Neurosurg. 2017 Nov;107:69-74. doi: 10.1016/j.wneu.2017.07.132. Epub 2017 Jul 30.
To analyze 3T magnetic resonance imaging (MRI) findings and clinical features of patients with trigeminal neuralgia (TN) who underwent percutaneous balloon compression and to determine whether these findings had an impact on prognosis of TN.
A retrospective review of patients with TN who underwent percutaneous balloon compression in the Neurosurgery Department at Istanbul Faculty of Medicine between January 1, 2007, and January 1, 2016, was undertaken. Of 105 patients who underwent percutaneous balloon compression, 27 patients who received surgical treatment for the first time for typical TN were included in the study. Follow-up data, clinical features, and 3T MRI findings were analyzed retrospectively. MRI findings and clinical features of patients with and without recurrence of TN were compared. The correlation between fractional anisotropy (FA) values and recurrence was investigated.
During follow-up, 9 (33%) patients had recurrence. The patients with recurrence had longer duration of symptoms (P = 0.032), higher FA difference (P = 0.042), and higher FA difference rate (P = 0.023). A trend toward early recurrence was found in patients with higher FA difference rate, although this was not significant (P = 0.051, R = 0.319).
Symptom duration was longer and microstructural changes were more apparent in patients with recurrence. In addition to age, comorbidities, and other clinical and radiographic features, symptom duration and FA values obtained with 3T MRI might be valuable information in surgical decision making.
分析接受经皮球囊压迫术的三叉神经痛（TN）患者的3T磁共振成像（MRI）表现及临床特征，并确定这些表现是否对TN的预后有影响。
对2007年1月1日至2016年1月1日在伊斯坦布尔医学院神经外科接受经皮球囊压迫术的TN患者进行回顾性研究。在105例行经皮球囊压迫术的患者中，纳入27例首次因典型TN接受手术治疗的患者。对随访数据、临床特征和3T MRI表现进行回顾性分析。比较TN复发和未复发患者的MRI表现及临床特征。研究分数各向异性（FA）值与复发之间的相关性。
随访期间，9例（33%）患者复发。复发患者的症状持续时间更长（P = 0.032），FA差值更高（P = 0.042），FA差值率更高（P = 0.023）。FA差值率较高的患者有早期复发的趋势，尽管差异无统计学意义（P = 0.051, R = 0.319）。
复发患者的症状持续时间更长，微观结构变化更明显。除年龄、合并症及其他临床和影像学特征外，症状持续时间和3T MRI获得的FA值可能是手术决策中有价值的信息。
