Effect of susceptibility-weighted imaging on preoperative evaluation of microvascular decompression in patients with trigeminal neuralgia

Objective: To assess the effectiveness of susceptibility-weighted imaging (SWI) in displaying the superior petrosal vein complex (SPVC) and the role of venous three-dimensional (3D) reconstruction in visualizing the anatomical relationship in patients with trigeminal neuralgia (TN). Methods: A total of 30 patients with primary TN who received treatment between September 2019 and December 2020 were enrolled prospectively in this study. All patients were examined with fast imaging employing steady-state acquisition (Fiesta), three-dimensional time of flight (3D-TOF) and SWI by the same technician. Image analysis was performed by 2 physicians. 3D reconstruction of nerves, arteries, and veins was performed with 3dslicer and compared with intraoperative findings. The general characteristics, vein description in MRI, and the composition of SPVC types were also compared. Results: The display effect of SPVC in SWI was significantly better than that in Fiesta and 3D-TOF (P < 0.05). The display effect of phase images was found to be superior to magnitude images (P < 0.05). The superior petrosal vein, pontotrigeminal vein, transverse pontine vein, and vein of the cerebellopontine fissure were clearly displayed in SWI. The anatomical relationship between SPVC and trigeminal nerve shown by 3D reconstruction of the vein was consistent with the findings observed during the operation. Conclusion: The SPVC can be clearly displayed by SWI. 3D reconstruction of the vein can accurately display the anatomical relationship between the trigeminal nerve and SPVC.

Automated summary

This study assessed the effectiveness of susceptibility-weighted imaging (SWI) in displaying the superior petrosal vein complex (SPVC) and the role of venous three-dimensional (3D) reconstruction in visualizing the anatomical relationship in patients with trigeminal neuralgia (TN). The results showed that SWI had a better display effect of SPVC compared to Fiesta and 3D-TOF. The 3D reconstruction of the vein accurately displayed the anatomical relationship between the trigeminal nerve and SPVC.