title: Preoperative evaluation of neurovascular relationship by using contrast-enhanced and unenhanced 3D time-of-flight MR angiography in patients with trigeminal neuralgia.
abstract: BACKGROUND
  Microvascular decompression is an etiological strategy for the therapy of trigeminal neuralgia (TN). Preoperative identification of neurovascular compression, therefore, could have an impact on the determination of appropriate treatment for TN.
  
  
  OBJECTIVE
  To evaluate the value of contrast-enhanced and unenhanced three-dimensional (3D) time-of-flight (TOF) MR angiography in the visualization of neurovascular relationship in patients with TN.
  
  
  METHODS
  Thirty-seven patients with unilateral TN underwent unenhanced and contrast-enhanced 3D TOF MR angiography with a 3.0-T MR system. Images were reviewed by a radiologist blinded to clinical details. Vascular contact with the trigeminal nerve was identified, and the nature of the involved vessels (artery or vein) was determined. All patients underwent microvascular decompression.
  
  
  RESULTS
  In 37 patients with TN, contrast-enhanced 3D TOF MR angiography identified surgically verified neurovascular contact in 35 of 36 symptomatic nerves, and there was no false-positive. Based on surgical findings, the sensitivity of MR imaging was 97.2% and specificity 100%. The nature of the offending vessel was correctly identified in 94.4% of the patients by using the combination of contrast-enhanced and unenhanced MR angiography.
  
  
  CONCLUSIONS
  Contrast-enhanced 3D TOF MR angiography is useful in the detection of vascular contact with the trigeminal nerve in patients with TN, and this MR imaging in combination with unenhanced MR angiography could help in the identification of the nature of the responsible vessels.
authors.affiliation: Department of Radiology, Qilu Hospital of Shandong University, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Zhou
authors.forename: Zhiling
authors.initials: Z
authors.lastname: Liu
authors.forename: Chuanfu
authors.initials: C
authors.lastname: Li
authors.forename: Chuncheng
authors.initials: C
authors.lastname: Qu
authors.forename: Shilei
authors.initials: S
authors.lastname: Ni
authors.forename: Qingshi
authors.initials: Q
authors.lastname: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D016896:Treatment Outcome; D014277:Trigeminal Neuralgia / Q000175:diagnosis* / Q000601:surgery
chemical_list: D003287:Contrast Media