The Role of 3D CISS MRI in the Evaluation of Primary Trigeminal Neuralgia Kadhim Mohammed abd1,*, Rasheed Rasha Muzahim2, Huweidy Bashar Talib3 1M.B. Ch. B., F.I.B.M.S., Professor, Medical collage, Al-Nahrain university, Consultant radiologist, Al-Imamian Al-Kadhimyian medical city, Baghdad, Iraq 2M.B. Ch. B. Radiologist, Al-Imamian Al-Kadhimyian medical city, Baghdad, Iraq 3Pediatrics Lecturer in Medical collage, AL-Fallujah University *Corresponding Author: Dr. Mohammed abd Kadhim M.B. Ch. B., F.I.B.M.S., Professor, Medical collage, Al-Nahrain university, Consultant radiologist, Al-Imamian, Al-Kadhimyian medical city, Baghdad, Iraq, e-mail: Dr_a_mohammed@yahoo.com
Online published on 23 December, 2019. Abstract Background Trigeminal neuralgia (TN) is the most common form of facial neuropathic pain characterized by recurrent episodes of unilateral brief electric shock-like pains localized to the sensory supply areas of trigeminal nerve. Aim of Study To study the role of axial and coronal 3D CISS MRI in the diagnosis of primary TN. Method this study is a cross sectional analytic study conducted in the MRI department at AL_Immamain AL_kadimian medical city during October 2017 and August 2018. The study included 30 patients with the clinical diagnosis of unilateral primary TN. Exclusion criteria were secondary cause of TN as brain tumor, MS, and other contraindication of MRI. MRI examination was done using 3 TESLA super conducting system. The patient were examined in the supine position by the following sequences: T1WI sagittal, T2WI axial, T2W FLIAR coronal, DWI, MRA/MIP MRA and 3D CISS (FFE/M) in axial and coronal orientation. Results Right and left sided complains represented 63.3% and 36.7%, respectively. Mean complain duration was 2.5±2.4 years. The compression was absent in 1 patient, arterial compression in 18 (60%) and venous compression in 11 (36.7%) patients. Arterial compression was related to superior cerebral artery in 83.3% and anterior inferior cerebral artery in 16.7%. Asignificant lower mean distance between compression vessels and root entry zone between symptomatic and control sides (p<0.001),. The appropriate cut off level for distance between compression vessels and REZ in prediction of primary TN was 3.1mm with 96.7% sensitivity and 96.6% specificity. Conclusions The 3D CISS MRI is an accurate imaging technique in diagnosis and evaluation of primary TN. The distance between compression vessels and REZ at symptomatic side is lower than opposite asymptomatic side. Top Keywords 3D CISS MRI, primary trigeminal neuralgia. Top |