University of Health Sciences, Department of Radiology, Ankara, Turkey.
University of Health Sciences, Department of Radiology, Ankara, Turkey.
Clin Imaging. 2021 Jun;74:93-99. doi: 10.1016/j.clinimag.2020.12.006. Epub 2021 Jan 14.
To investigate normal quantitative proton magnetic resonance spectroscopy (MRS) features of the cisternal segment of the trigeminal nerve and evaluate possible metabolite concentration differences in the affected and unaffected nerves of trigeminal neuralgia patients.
A total of 33 consecutive patients who underwent a MR study of the internal auditory canal/posterior fossa and dedicated trigeminal nerve multivoxel MRS were enrolled. Measurements of N-acetyl aspartate (NAA), creatine (Cr), choline (Cho), myoinositol (mI), glutamate-glutamine (Glx) concentrations, and ratios of NAA-to-Cr, Cho-to-Cr, and Cho-to-NAA were automatically calculated by the dedicated software. Vascular conflicts were also recorded.
The mean Cr concentration was significantly higher on the affected sides in all parts of the nerve (p < 0.05), while the mean NAA concentration was significantly higher in only the distal portion (p = 0.04). Mean mI concentration was significantly higher in the middle and distal parts (p < 0.05). NAA-to-Cr ratio was significantly higher in the proximal and middle parts (p < 0.05), while Cho-to-Cr ratio was significantly higher only in the middle portion (p = 0.028). Finally, the Cho-to-NAA ratio was significantly higher only in the distal portion (p = 0.04). Vascular conflicts were observed in 24 patients (72.7%), and in 20 of them (60.6%) the conflict was on the same side as the neuralgia symptoms.
Although the detected statistical relationships were variable in the spectroscopic measurements, metabolite concentrations and ratios were successfully exhibited in all patients. Features of a normal trigeminal nerve were able to determine by MRS. All calculated metabolite concentrations were higher in the affected nerves; however, only some of them were statistically significant. No statistically significant relationships were found between the MRS measurements and nerves with and without vascular compression.
研究正常三叉神经池段质子磁共振波谱（MRS）的定量特征，并评估三叉神经痛患者患侧和未患侧神经中可能存在的代谢物浓度差异。
共纳入 33 例连续患者，这些患者均进行了内听道/后颅窝的磁共振研究和专门的三叉神经多体素 MRS。通过专用软件自动计算 N-乙酰天冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho）、肌醇（mI）、谷氨酸-谷氨酰胺（Glx）浓度以及 NAA/Cr、Cho/Cr 和 Cho/NAA 的比值。还记录了血管冲突。
在神经的所有部位，患侧的 Cr 浓度均显著高于健侧（p<0.05），而只有在远端部位 NAA 浓度显著升高（p=0.04）。中间和远端部位 mI 浓度显著升高（p<0.05）。近端和中间部分 NAA/Cr 比值显著升高（p<0.05），而 Cho/Cr 比值仅在中间部分显著升高（p=0.028）。最后，只有在远端部位 Cho/NAA 比值显著升高（p=0.04）。24 例患者（72.7%）观察到血管冲突，其中 20 例（60.6%）冲突与神经痛症状同侧。
尽管在光谱测量中检测到的统计关系各不相同，但成功地在所有患者中显示了代谢物浓度和比值。MRS 能够确定正常三叉神经的特征。所有计算的代谢物浓度在患侧神经中均升高；然而，只有一些具有统计学意义。MRS 测量与有或无血管压迫的神经之间未发现统计学显著关系。
