Eur Radiol. 2022 Mar 23. doi: 10.1007/s00330-022-08611-y. Online ahead of print.
ABSTRACT
OBJECTIVES: This study was performed amongst trigeminal neuralgia (TN) patients with neurovascular contact (NVC) to 1) investigate the association of the demographic and radiologic factors/variables with TN occurrence, and 2) develop a screening tool for TN/TN-affected nerves based on the factors/variables associated with it.
METHODS: Eighty-five TN patients were recruited, and 121 trigeminal nerves with NVC were derived from them. Based on MRI sequences, including balanced turbo field echo and enhanced T1 high-resolution isotropic volume excitation, radiologic factors/variables for each nerve, from the offending vessel to the presence of nerve displacement, were identified by a neuroradiologist and a neurosurgeon. Demographic and clinical data were obtained from clinical notes. Logistic regression was performed to assess the association of the factors/variables with TN occurrence (i.e., affected vs. unaffected nerves).
RESULTS: Three factors/variables were significantly (p < 0.05) associated with TN occurrence amongst patients with NVC: nerve laterality, vertebral artery (VA) involvement, and the presence of nerve displacement. The nerves with VA involvement, those on the right side, and those with nerve displacement exhibited a significantly higher likelihood/odd of being affected by TN, compared to those without VA involvement, those on the left side, and those without nerve displacement, respectively. Based on these factors/variables, a screening tool/nomogram with acceptable accuracy was established (C-statistic/AUC = 0.80).
CONCLUSIONS: This study revealed an association of the three radiologic factors/variables with TN occurrence. A screening tool for TN/TN-affected nerves was established based on them. The findings may lay a foundation for an improvement of the diagnosis and clinical management of TN.
KEY POINTS: • VA involvement and nerve displacement could be identified using MRI, and are significantly associated with TN occurrence. • A potential objective screening tool/nomogram for TN/TN-affected nerves could be established based on the three radiologic factors/variables: VA involvement, the presence of nerve displacement, and nerve laterality. • The screening accuracy of the tool/nomogram is acceptable as the C-statistic is 0.80.
PMID:35320409 | DOI:10.1007/s00330-022-08611-y
