Department of Radiology, The Second Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.
Korean J Radiol. 2022 Aug;23(8):821-827. doi: 10.3348/kjr.2021.0771. Epub 2022 May 27.
To determine the anatomical characteristics of the petrous ridge and trigeminal nerve in trigeminal neuralgia (TN) without neurovascular compression (NVC).
From May 2017 to March 2021, 66 patients (49 female and 17 male; mean age ± standard deviation [SD], 56.8 ± 13.3 years) with TN without NVC and 57 controls (46 female and 11 male; 52.0 ± 15.6 years) were enrolled. The angle of the petrous ridge (APR) and angle of the trigeminal nerve (ATN) were measured using magnetic resonance imaging with a high-resolution three-dimensional T2 sequence. Data on the symptomatic side were compared with those on the asymptomatic side in patients and with the mean measurements of the bilateral sides in controls. Receiver operating characteristic (ROC) analysis was conducted to evaluate the performance of APR and ATN in distinguishing TN patients from controls.
In TN patients without NVC, the mean ± standard deviation (SD) of APR on the symptomatic side (98.40° ± 19.75°) was significantly smaller than that of the asymptomatic side (105.59° ± 22.45°, = 0.019) and controls (108.44° ± 15.98°, = 0.003). The mean ATN ± SD on the symptomatic side (144.41° ± 8.92°) was significantly smaller than that of the asymptomatic side (149.67° ± 8.09°, = 0.003) and controls (150.45° ± 8.48°, = 0.001). The area under the ROC curve for distinguishing TN patients from controls was 0.673 (95% confidence interval [CI]: 0.579-0.758) for APR and 0.700 (CI: 0.607-0.782) for ATN. The sensitivity and specificity using the diagnostic cutoff yielding the highest Youden index were 81.8% (54/66) and 49.1% (28/57), respectively, for APR (with a cutoff score of 94.30°) and 65.2% (43/66) and 66.7% (38/57), respectively, for ATN (cutoff score, 148.25°).
In patients with TN without NVC, APR and ATN were smaller than those in controls, which may explain the potential cause of TN and provide additional information for diagnosis.
确定无神经血管压迫（NVC）三叉神经痛（TN）患者岩嵴和三叉神经的解剖学特征。
自 2017 年 5 月至 2021 年 3 月，纳入 66 例（49 名女性和 17 名男性；平均年龄±标准差[SD]，56.8±13.3 岁）无 NVC 的 TN 患者和 57 例对照者（46 名女性和 11 名男性；52.0±15.6 岁）。采用高分辨率三维 T2 序列的磁共振成像测量岩嵴角（APR）和三叉神经角（ATN）。比较患者患侧与无症状侧、对照组双侧平均值的数据。受试者工作特征（ROC）分析评估 APR 和 ATN 鉴别 TN 患者与对照者的效能。
在无 NVC 的 TN 患者中，患侧 APR 的平均值±SD（98.40°±19.75°）明显小于无症状侧（105.59°±22.45°， =0.019）和对照组（108.44°±15.98°， =0.003）。患侧 ATN 的平均值±SD（144.41°±8.92°）明显小于无症状侧（149.67°±8.09°， =0.003）和对照组（150.45°±8.48°， =0.001）。APR 鉴别 TN 患者与对照者的 ROC 曲线下面积为 0.673（95%置信区间[CI]：0.579-0.758），ATN 为 0.700（CI：0.607-0.782）。采用最大 Youden 指数的诊断截断值时，APR 的灵敏度和特异度分别为 81.8%（54/66）和 49.1%（28/57），APR 的截断值为 94.30°；ATN 的灵敏度和特异度分别为 65.2%（43/66）和 66.7%（38/57），ATN 的截断值为 148.25°。
在无 NVC 的 TN 患者中，APR 和 ATN 小于对照者，这可能解释了 TN 的潜在原因，并为诊断提供了额外信息。
