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. 2018 Feb 15;58(2):71-78.
doi: 10.2176/nmc.oa.2017-0157. Epub 2017 Nov 14.

Prognostic Impact and Post-operative Evaluation of Volumetric Measurement of the Cerebellopontine Cistern in Trigeminal Neuralgia Using 3 Tesla Magnetic Resonance Imaging

Yoshiki Obata  1 , Yoshihisa Kawano  1   2 , Yoji Tanaka  1 , Taketoshi Maehara  1
Affiliations

Prognostic Impact and Post-operative Evaluation of Volumetric Measurement of the Cerebellopontine Cistern in Trigeminal Neuralgia Using 3 Tesla Magnetic Resonance Imaging

Yoshiki Obata et al. Neurol Med Chir (Tokyo). .

Abstract

The aim of this study was to evaluate the importance of pre- and post-operative volumetric measurement of the cerebellopontine angle (CPA) using 3 Tesla (3T) magnetic resonance imaging (MRI). Between April 2012 and December 2015, a total of 87 consecutive patients underwent microvascular decompression (MVD) for trigeminal neuralgia (TN), of whom 51 with primary TN caused by arterial compression were enrolled in this study. Bilateral CPA cistern volume was evaluated using 3T MRI before and after surgery; the Cistern Deviation Index was used to represent the degree of deviation of the CPA cistern. The relationships between CPA cistern volume and the etiology of TN were assessed, and post-operative changes in anatomical parameters were examined to determine differences between recurrent and non-recurrent patients with TN. The mean volume of the CPA cistern on the affected side was significantly smaller than the unaffected side (P < 0.001). Five of 51 (10%) patients experienced TN recurrence. The recurrent cases demonstrated significantly lower pre-operative Cistern Deviation Index scores than non-recurrent cases (P = 0.035). On the unaffected side-but not the affected side-post-operative volume reduction was significantly greater in the recurrence group than in the non-recurrence group (P = 0.004). The pre-operative Cistern Deviation Index was a useful parameter to predict the recurrence of TN. In recurrent patients, post-operative inflammatory reaction may extend to not only the operated side but also the healthy side and reduce the volume of the CPA cistern.

Keywords: cerebellopontine angle cistern; magnetic resonance imaging; microvascular decompression; trigeminal neuralgia.

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Conflict of interest statement

Conflicts of Interest Disclosure

The authors have no conflicts of interest to declare. All authors who are members of the Japan Neurosurgical Society (JNS) have registered online, self-reported COI Disclosure Statement forms through the Journal’s website.

Figures

Fig. 1.
Fig. 1.
Pre- (A, B) and post-operative (C, D) fast imaging employing steady-state acquisition (FIESTA) of a 67-year-old woman with recurrent left-sided trigeminal neuralgia exhibiting severe post-operative volume reduction in the affected cerebellopontine angle (CPA) cistern (yellow enclosed area), and mild reduction in the unaffected CPA angle cistern (green enclosed area). The CPA cistern volume of eight images was measured in this case. On the affected left side, pre-operative CPA cistern volume was 204.7 mm3, and post-operative volume was 153.1 mm3. On the unaffected right side, pre-operative CPA cistern volume was 232.3 mm3, and post-operative volume was 219.1 mm3.
See this image and copyright information in PMC

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