Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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MRI Findings in Trigeminal Neuralgia without Neurovascular Compression: Implications of Petrous Ridge and Trigeminal Nerve Angles

  • Hai Zhong (Department of Radiology, The Second Hospital, Cheeloo College of Medicine, Shandong University) ;
  • Wenshuang Zhang (Department of Radiology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University) ;
  • Shicheng Sun (Department of Neurosurgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University) ;
  • Yifan Bie (Department of Radiology, The Second Hospital, Cheeloo College of Medicine, Shandong University)
  • Received : 2021.10.04
  • Accepted : 2022.04.27
  • Published : 2022.08.01
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Abstract

Objective: To determine the anatomical characteristics of the petrous ridge and trigeminal nerve in trigeminal neuralgia (TN) without neurovascular compression (NVC). Materials and Methods: From May 2017 to March 2021, 66 patients (49 female and 17 male; mean age ± standard deviation [SD], 56.8 ± 13.3 years) with TN without NVC and 57 controls (46 female and 11 male; 52.0 ± 15.6 years) were enrolled. The angle of the petrous ridge (APR) and angle of the trigeminal nerve (ATN) were measured using magnetic resonance imaging with a high-resolution three-dimensional T2 sequence. Data on the symptomatic side were compared with those on the asymptomatic side in patients and with the mean measurements of the bilateral sides in controls. Receiver operating characteristic (ROC) analysis was conducted to evaluate the performance of APR and ATN in distinguishing TN patients from controls. Results: In TN patients without NVC, the mean ± standard deviation (SD) of APR on the symptomatic side (98.40° ± 19.75°) was significantly smaller than that of the asymptomatic side (105.59° ± 22.45°, p = 0.019) and controls (108.44° ± 15.98°, p = 0.003). The mean ATN ± SD on the symptomatic side (144.41° ± 8.92°) was significantly smaller than that of the asymptomatic side (149.67° ± 8.09°, p = 0.003) and controls (150.45° ± 8.48°, p = 0.001). The area under the ROC curve for distinguishing TN patients from controls was 0.673 (95% confidence interval [CI]: 0.579-0.758) for APR and 0.700 (CI: 0.607-0.782) for ATN. The sensitivity and specificity using the diagnostic cutoff yielding the highest Youden index were 81.8% (54/66) and 49.1% (28/57), respectively, for APR (with a cutoff score of 94.30°) and 65.2% (43/66) and 66.7% (38/57), respectively, for ATN (cutoff score, 148.25°). Conclusion: In patients with TN without NVC, APR and ATN were smaller than those in controls, which may explain the potential cause of TN and provide additional information for diagnosis.

Keywords

Acknowledgement

We thank International Science Editing (http://www.internationalscienceediting.com) for editing this manuscript.

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