Preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia by use of three-dimensional reconstruction from two types of high-resolution magnetic resonance imaging.
OBJECTIVE
To assess the value of three-dimensional (3-D) images reconstructed from 3-D constructive interference in steady state (3-D-CISS) and 3-D fast inflow with steady-state precession (3-D-FISP) images for the visualization of neurovascular compression in patients with trigeminal neuralgia.


METHODS
Twenty-four consecutive patients with trigeminal neuralgia underwent preoperative 3-D-FISP and 3-D-CISS imaging. 3-D reconstruction of nerves and vessels was performed with the use of a volume-rendering method. We compared the 3-D reconstructed images with intraoperative findings.


RESULTS
3-D-CISS and 3-D-FISP images scanned from the same position clearly delineated the trigeminal nerve and vessels. 3-D reconstructed images showed the spatial relationship between the trigeminal nerve and causative vessels. The responsible arteries were identified from the 3-D reconstructed images, which closely simulated the microscopic operative view.


CONCLUSIONS
3-D reconstructions from two types of high-resolution magnetic resonance images (3-D-CISS and 3-D-FISP) are very useful for creating preoperative simulations and in deciding whether to perform surgery in patients with trigeminal neuralgia.
Akimoto
Hideaki
H
Department of Neurosurgery, Tokyo Medical and Dental University, Japan. akinsrg@plum.ocn.ne.jp
Nagaoka
Tsukasa
T
Nariai
Tadashi
T
Takada
Yoshiaki
Y
Ohno
Kikuo
K
Yoshino
Norio
N
D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000150:complications* / Q000175:diagnosis*; D016896:Treatment Outcome; D014276:Trigeminal Nerve / Q000098:blood supply*; D014277:Trigeminal Neuralgia / Q000209:etiology* / Q000601:surgery; D014652:Vascular Diseases / Q000150:complications* / Q000175:diagnosis