Tian Xinbo, Tong Jing, Gao Qianqian, Li Yuze
Department of Radiology, Center for Neuroimaging, General Hospital of Northern Theater Command, Shenyang, P. R. China; Dalian Medical University, General Hospital of Northern Theater Command, Postgraduate Training Base, Shenyang, P. R. China.
Department of Radiology, Center for Neuroimaging, General Hospital of Northern Theater Command, Shenyang, P. R. China.
World Neurosurg. 2025 Jul;199:124125. doi: 10.1016/j.wneu.2025.124125. Epub 2025 May 28.
Neurovascular conflict (NVC) is commonly observed in patients with hemifacial spasm (HFS); in certain instances, NVC can also be identified on the asymptomatic side of patients with HFS through magnetic resonance imaging (MRI). It is vital to evaluate NVC in asymptomatic individuals and patients with HFS before performing microvascular decompression (MVD). The aim of this study was to evaluate the role of the MRI three-dimensional volumetric interpolated breath-hold examination (3D-VIBE) sequence in distinguishing NVC in asymptomatic individuals and patients with HFS.
We reviewed the magnetic resonance images of NVC on both the symptomatic and asymptomatic sides in patients with HFS undergoing MVD. All patients underwent MRI with 3D-VIBE sequence. The same neuroradiologist blindly described the differences of magnetic resonance images, including the location of NVC (root exit zone or cisternal segment of the facial nerve), severity of NVC (mild or severe), offending vessels, vertebral artery (VA) dominance, and VA tortuosity with 3D-VIBE in asymptomatic and symptomatic nerves.
One hundred twelve patients who underwent MVD for HFS were enrolled in this study. In total, 104 patients with HFS met the inclusion criteria. Of these, the asymptomatic sides of 52 patients were included in the asymptomatic control group. Severe compression at the root exit zone and VA tortuosity were more commonly observed in symptomatic nerves than in contralateral asymptomatic nerves (P values < 0.05).
We conclude that the 3D-VIBE sequence is a reliable noninvasive tool for evaluating NVC in asymptomatic individuals and patients with HFS. There were differences in the location, type of blood vessel, and severity of NVC in the 3D-VIBE sequence between asymptomatic individuals and patients with HFS. Knowledge of the MRI characteristics of frequent NVC in asymptomatic individuals is essential for evaluating and selecting the appropriate treatment.
面肌痉挛（HFS）患者中常见神经血管冲突（NVC）；在某些情况下，通过磁共振成像（MRI）也可在HFS患者的无症状侧发现NVC。在进行微血管减压术（MVD）之前，评估无症状个体和HFS患者的NVC至关重要。本研究的目的是评估MRI三维容积插值屏气检查（3D-VIBE）序列在区分无症状个体和HFS患者的NVC中的作用。
我们回顾了接受MVD的HFS患者有症状侧和无症状侧的NVC磁共振图像。所有患者均接受了3D-VIBE序列的MRI检查。同一位神经放射科医生在不知情的情况下描述了磁共振图像的差异，包括NVC的位置（面神经根部出口区或脑池段）、NVC的严重程度（轻度或重度）、肇事血管、椎动脉（VA）优势以及无症状和有症状神经中3D-VIBE显示的VA迂曲情况。
本研究纳入了112例因HFS接受MVD的患者。总共有104例HFS患者符合纳入标准。其中，52例患者的无症状侧被纳入无症状对照组。有症状神经比同侧无症状神经更常观察到根部出口区的严重压迫和VA迂曲（P值<0.05）。
我们得出结论，3D-VIBE序列是评估无症状个体和HFS患者NVC的可靠无创工具。无症状个体和HFS患者在3D-VIBE序列中NVC的位置、血管类型和严重程度存在差异。了解无症状个体中常见NVC的MRI特征对于评估和选择合适的治疗方法至关重要。
