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196 High-Resolution Magnetic Resonance Imaging in Trigeminal Neuralgia: Added Benefit of Contrast Enhanced Constructive Interference in Steady State Imaging.

Publication ,  Journal Article
Goodwin, CR; Seeburg, D; Northcutt, B; Shin, J; Theodros, D; Abu-Bonsrah, NA; Herzka, D; Aygun, N; Blitz, AM; Lim, M
Published in: Neurosurgery
August 2016

INTRODUCTION: MRI is performed in the assessment of patients with trigeminal neuralgia (TGN). However, there is poor contrast between vessels and nerves, because both are low in intensity on heavily T2-weighted images. METHODS: A retrospective review was performed of high-resolution 3D MRI studies of patients from 2011 to 2014. Eighty-one TGN patients and 15 controls were independently reviewed by 2 neuroradiologists in a blinded fashion. The cisternal segment of the trigeminal nerve root was assessed bilaterally for metrics of neurovascular conflict, including grade (0-3), nerve root cross-sectional area (CSA), and degree of flattening (DOF). The data were correlated with side of symptoms and postoperative pain relief after microvascular decompression (MVD). RESULTS: Grade 1 neurovascular conflict was prevalent on both the asymptomatic side (59.3%) and in controls (60%), but advanced grade neurovascular conflict was rare on the asymptomatic side (7.4%) and not seen in controls (0%). Grade 3 neurovascular conflict occurred in 46.9% on the symptomatic side, but was highly specific for that side (94.6%). Review of contrast-enhanced 3D constructive interference in steady state (CISS) imaging (CE-CISS) more than doubled the prevalence of grade 3 neurovascular conflict (14.8% vs 33.3%, P = .001), and yielded lower CSA and greater DOF for advanced grade neurovascular conflict on the side of symptoms compared with imaging without contrast (NE-CISS). Patients with complete pain relief after MVD had significantly lower CSA on CE-CISS compared with NE-CISS on preoperative imaging. The area under the curve (AUC) for predicting complete relief of symptoms after MVD was significantly higher for CE-CISS than for NE-CISS for grade of neurovascular conflict (AUC = 0.835 vs 0.803, P = .017) and CSA (AUC = 0.709 vs 0.682, P = .002). CONCLUSION: The addition of gadolinium-based contrast to 3D-CISS imaging improves performance in predicting the side of symptoms in patients with TGN and in predicting favorable outcomes after MVD, which may be helpful in preoperative planning.

Duke Scholars

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

August 2016

Volume

63 Suppl 1

Start / End Page

177

Location

United States

Related Subject Headings

  • Trigeminal Neuralgia
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Magnetic Resonance Imaging
  • Humans
  • Gadolinium
  • Contrast Media
  • 5202 Biological psychology
  • 3209 Neurosciences
  • 3202 Clinical sciences
 

Citation

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MLA
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Goodwin, C. R., Seeburg, D., Northcutt, B., Shin, J., Theodros, D., Abu-Bonsrah, N. A., … Lim, M. (2016). 196 High-Resolution Magnetic Resonance Imaging in Trigeminal Neuralgia: Added Benefit of Contrast Enhanced Constructive Interference in Steady State Imaging. Neurosurgery, 63 Suppl 1, 177. https://doi.org/10.1227/01.neu.0000489925.89468.00
Goodwin, C Rory, Daniel Seeburg, Benjamin Northcutt, Jaehoon Shin, Debebe Theodros, Nancy A. Abu-Bonsrah, Daniel Herzka, Nafi Aygun, Ari M. Blitz, and Michael Lim. “196 High-Resolution Magnetic Resonance Imaging in Trigeminal Neuralgia: Added Benefit of Contrast Enhanced Constructive Interference in Steady State Imaging.Neurosurgery 63 Suppl 1 (August 2016): 177. https://doi.org/10.1227/01.neu.0000489925.89468.00.
Goodwin CR, Seeburg D, Northcutt B, Shin J, Theodros D, Abu-Bonsrah NA, et al. 196 High-Resolution Magnetic Resonance Imaging in Trigeminal Neuralgia: Added Benefit of Contrast Enhanced Constructive Interference in Steady State Imaging. Neurosurgery. 2016 Aug;63 Suppl 1:177.
Goodwin, C. Rory, et al. “196 High-Resolution Magnetic Resonance Imaging in Trigeminal Neuralgia: Added Benefit of Contrast Enhanced Constructive Interference in Steady State Imaging.Neurosurgery, vol. 63 Suppl 1, Aug. 2016, p. 177. Pubmed, doi:10.1227/01.neu.0000489925.89468.00.
Goodwin CR, Seeburg D, Northcutt B, Shin J, Theodros D, Abu-Bonsrah NA, Herzka D, Aygun N, Blitz AM, Lim M. 196 High-Resolution Magnetic Resonance Imaging in Trigeminal Neuralgia: Added Benefit of Contrast Enhanced Constructive Interference in Steady State Imaging. Neurosurgery. 2016 Aug;63 Suppl 1:177.
Journal cover image

Published In

Neurosurgery

DOI

EISSN

1524-4040

Publication Date

August 2016

Volume

63 Suppl 1

Start / End Page

177

Location

United States

Related Subject Headings

  • Trigeminal Neuralgia
  • Retrospective Studies
  • Neurology & Neurosurgery
  • Magnetic Resonance Imaging
  • Humans
  • Gadolinium
  • Contrast Media
  • 5202 Biological psychology
  • 3209 Neurosciences
  • 3202 Clinical sciences