DTI predicts the surgical outcome of trigeminal neuralgia

Trigeminal neuralgia (TN) is characterized by paroxysmal facial electric shock pain. Microvascular decompression (MVD) can alleviate the pain caused by vascular compression of the trigeminal nerve into the pons (REZ). Gamma knife radiotherapy (GKRS) can Treatment of pain caused by abnormalities in the cerebral cistern of the trigeminal nerve. Most patients can get pain relief through surgery, but 20% of patients still have no postoperative pain or relapse. Predicting the efficacy of pain is essential to help optimize treatment options and reduce unnecessary measures. Peter S.-P. Hung et al., Western Hospital of Toronto, Ontario, Canada, used MRI diffusion tensor imaging (DTI) to detect the dispersion characteristics of trigeminal nerve micro-structures and predict the surgical outcome of trigeminal neuralgia. The results were published in June 2017. NeuroImage: Clinical magazine.

The study included 31 patients with primary trigeminal neuralgia who had not previously received surgery. According to the occurrence of trigeminal neuralgia in one year after operation, 17 patients were divided into long-term effective group, 14 patients to the ineffective group, and 16 healthy adults were used as the control group. The image of the trigeminal nerve fiber structure was obtained by the extended streamline tractography (XST), which was divided into three segments according to the anatomical position: the brain pool segment (CS), the REZ region and the pons segment (PS). The three-stage ROI region is located in Figure 1; the dispersion parameters of each segment: anisotropy fraction (FA), average dispersion value (MD), axial dispersion value (AD), and radial dispersion value (RD), from each segment The ROI area is obtained.

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