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Analysis of magnetic resonance tomographic angiography false negatives in trigeminal neuralgia before microvascular decompression

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Abstract

Objectives

The aim of this study was to clarify the reason for the high rate of false-negative cases for offending vessels determined by magnetic resonance tomographic angiography (MRTA) in trigeminal neuralgia (TN) patients before microvascular decompression (MVD).

Methods

Preoperative MRTA imaging was performed in 115 patients with TN. The characteristics of the offending vessels were determined by MRTA prior to MVD. The relationships between TN and surrounding vessels were classified into two types, MRTA-positive (contact or compressing) and MRTA-negative (near or distant), and compared with the surgical findings.

Results

According to the surgical findings in the 100 MRTA-positive patients, vascular compression was found in 90 patients, vascular contact without compression was found in six patients, and no contact between vessels and the root of TN was found in three patients. Bony compression was found in one patient. In the 15 MRTA-negative patients, small artery compression (one with arterial wall stiffening) was found in seven patients, venous compression was found in two patients, arachnoid thickening and adhesion were found in three patients, and no vessel compression was found in three patients. MRTA showed sensitivity of 91.4 % (96/105) and specificity of 60 % (6/10).

Conclusions

Preoperative MRTA is valuable for determining the offending vessels in TN patients. However, owing to its inability to distinguish offending vessels such as small arteries, small veins, and vessels with wall calcification in addition to abnormal blood flow, the false-negative rate is comparably high.

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Authors and Affiliations

  1. Department of Neurosurgery, People’s Hospital of Liaoning Province, 33 Wenyi Road, Shenhe, Shenyang, 110016, Liaoning, China

    Haitao Huang, Yi Ma & Yanfeng Li

  2. Department of Oral Radiology and Center for Orofacial Pain, Peking University School of Stomatology, 22 Zhongguancun S St, Haidian, Beijing, 100081, China

    Zhihui Wang

  3. Graduate School of Dalian Medical University, 9 Lvshun South Rd West Section, Lvshunkou, Dalian, 116044, Liaoning, China

    Lei Wang & Guofei Wang

  4. Department of Radiology, People’s Hospital of Liaoning Province, 33 Wenyi Road, Shenhe, Shenyang, 110016, Liaoning, China

    Qiang Ma

  5. Oral Imaging Center, Dalian Medical University, 9 Lvshun South Rd West Section, Lvshunkou, Dalian, 116044, Liaoning, China

    Xin Liang

Authors
  1. Haitao Huang
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  2. Zhihui Wang
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  3. Yi Ma
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  4. Yanfeng Li
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  5. Lei Wang
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  6. Guofei Wang
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  7. Qiang Ma
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  8. Xin Liang
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Corresponding author

Correspondence to Haitao Huang.

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Conflict of interest

Haitao Huang, Zhihui Wang, Yi Ma, Yanfeng Li, Lei Wang, Guofei Wang, Qiang Ma, and Xin Liang declare that they have no conflict of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Informed consent was obtained from all patients for being included in the study.

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Huang, H., Wang, Z., Ma, Y. et al. Analysis of magnetic resonance tomographic angiography false negatives in trigeminal neuralgia before microvascular decompression. Oral Radiol 33, 45–50 (2017). https://doi.org/10.1007/s11282-016-0247-7

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  • DOI: https://doi.org/10.1007/s11282-016-0247-7

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