J Oral Facial Pain Headache. 2021;35(1):35-40. doi: 10.11607/ofph.2732.
To evaluate the diagnostic value of non-nerve-selective MRI sequences in posttraumatic trigeminal neuropathic pain (PTNP).
This study retrospectively analyzed all MRI protocols performed between February 2, 2012 and June 20, 2018 commissioned by the Department of Oral and Maxillofacial Surgery, University Hospitals Leuven. Demographic, clinical, and radiologic data were extracted from the records of patients with an MRI in the context of PTNP. A contingency table was constructed based on the opinions of the treating physician and the radiologist who initially evaluated the MRI. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated.
The sample consisted of 27 women (65.9%) and 14 men (34.1%). The sensitivity and negative predictive value of MRI in PTNP were 0.18 and 0.77, respectively. Artifacts interfered with visualization of a possible cause of the trigeminal pain in 24.4% of MRIs. Almost all artifacts (90%) were caused by metal debris originating from the causal procedure or posttraumatic surgeries. MRI resulted in changed management for PTNP patients only once.
The diagnostic value of non-nerve-selective MRI sequences for PTNP is low and has little impact on clinical management. Therefore, there is a need for dedicated sequences with high resolution and low artifact susceptibility for visualizing the posttraumatic injuries of the trigeminal branches.
评估非神经选择性 MRI 序列在后创伤性三叉神经病理性疼痛（PTNP）中的诊断价值。
本研究回顾性分析了 2012 年 2 月 2 日至 2018 年 6 月 20 日期间由鲁汶大学附属医院口腔颌面外科委托进行的所有 MRI 方案。从 PTNP 患者的 MRI 记录中提取人口统计学、临床和影像学数据。根据治疗医生和最初评估 MRI 的放射科医生的意见构建列联表。计算了敏感性、特异性、阳性预测值和阴性预测值。
样本包括 27 名女性（65.9%）和 14 名男性（34.1%）。MRI 在 PTNP 中的敏感性和阴性预测值分别为 0.18 和 0.77。MRI 中 24.4%的伪影干扰了对三叉神经疼痛可能原因的可视化。几乎所有的伪影（90%）都是由源自病因程序或创伤后手术的金属碎片引起的。MRI 仅导致 1 次改变了对 PTNP 患者的治疗管理。
非神经选择性 MRI 序列对 PTNP 的诊断价值较低，对临床管理的影响较小。因此，需要具有高分辨率和低伪影易感性的专用序列来可视化三叉神经分支的创伤后损伤。
