Application of 3D-TOF-MRA to diagnosis of neuropathy induced by microvascular compression

Objective To enhance the level of judging the responsible vessels for the neuropathy induced by microvascular compression such as trigeminal neuroglia(TN), hemifacial spasm(HFS) and glossopharyngeal neuralgia(GPN). Methods Three dimensional time-of-flight magnetic resonance angiography(3D-TOF-MRA) and MR reconstruction were performed in 30 patients with the neuropathy, of whom, 11 suffered from TN,17 HFS, 1 recurrent GPN and 1 both TN and HFS. The outcomes of 3D-TOF-MRA examination were compared with those observed during microvascular decompression(MVD), which was performed in all the patients. Results The responsible vessels for the neuropathy which were preoperatively found in 28 patients by 3D-TOF-MRA were verified by MVD. The responsible vessels were not found by the preoperative 3D-TOF-MRA in 2 patients with TN, in whom, it was observed during MVD that the root exit zoons (REZ) of the trigeminal nerves were pressed respectively by the basilar artery and suspicious multibranch arterioles of superior cerebellar artery. MVD and selective trigeminal sensory root rhizotomy was performed in the patients with TN induced by the suspicious compression. The symptoms were totally alleviated in 26 patients and significantly alleviated in 4 patients after the operation. Conclusion The 3D-TOF-MRA combined with MR reconstruction is very helpful to the judgment of the responsible vessels and surgical design in the patients with neuropathy induced by vascular compression.