Symptoms and signs related to the trigeminal nerve: diagnostic yield of MR imaging.
OBJECTIVE
To assess the diagnostic yield of magnetic resonance (MR) imaging in patients with symptoms and signs related to the trigeminal nerve.


METHODS
Medical records and MR imaging studies in 112 consecutive patients referred for MR imaging over 5 years were evaluated. MR images were independently reviewed by two neuroradiologists unaware of the clinical findings. Signs and symptoms at presentation were associated with either a positive or negative MR imaging outcome. Logistic regression analysis was performed to identify clinical variables related to imaging results.


RESULTS
Sixty-eight (61%) patients had positive MR imaging findings related to symptoms and signs. Trigeminal neuralgia was correlated with a negative MR imaging outcome (P < .001). Numbness (P < .01), impaired sensation (P < .001), other neurologic symptoms and signs (P < .01), progression of symptoms and signs (P < .001), and duration of symptoms of less than 1 year (P < .001) corresponded to a positive MR imaging outcome. Two regression models, each with three clinical parameters (progression, duration < 1 year, and trigeminal neuralgia or impaired sensation), had comparable accuracy for prediction of the MR imaging outcome.


CONCLUSIONS
Clinical findings can be used to identify groups in which a high or a low yield of MR imaging is correlated with symptoms and signs related to the trigeminal nerve.
Majoie
C B
CB
Department of Radiology, University of Amsterdam, The Netherlands.
Hulsmans
F J
FJ
Castelijns
J A
JA
Verbeeten
B
B
Tiren
D
D
van Beek
E J
EJ
Valk
J
J
Bosch
D A
DA
D003389:Cranial Nerve Diseases / Q000175:diagnosis; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010292:Paresthesia / Q000175:diagnosis; D011237:Predictive Value of Tests; D014276:Trigeminal Nerve / Q000473:pathology*; D014277:Trigeminal Neuralgia / Q000175:diagnosis*