PDF(Pubmed)
Abstract：
Trigeminal neuralgia (TN) is a debilitating disorder causing severe, episodic, unilateral stabbing facial pain disturbing enough to disrupt the activities of daily life. Classic TN is caused due to compression injury of the trigeminal nerve at the cistern segment caused by either an artery or a vein, referred to as neurovascular contact or conflict (NVC). Magnetic resonance imaging (MRI) has been the standard tool for the diagnosis of NVC. This study aimed to determine the incidence of NVC in TN, as identified by MRI, assess the various MRI grading patterns among patients with TN, and identify the vessels primarily involved in NVC. A systematic search of studies that used MRI for the diagnosis of TN in reference to NVC was conducted on DOAJ and PubMed/PubMed Central. Data were extracted and entered into a Microsoft Excel spreadsheet. The outcomes measured were the incidence of NVC as shown in MRI, vessels involved in NVC, and MRI grading patterns. We identified and selected 20 studies that fulfilled inclusion/exclusion criteria. In total, 1,436 patients were enrolled in all included studies. The type of MRI used was 1.5 T or 3 T MRI. The mean age of the patients varied from 49 to 63 years, with an equivalent male-to-female ratio. NVC was seen in 1,276 cases out of 1,436 cases (88.85%) of TN on the ipsilateral side, as shown by MRI. The vessels involved were arteries in 80-90% of the cases, followed by veins. Among the arteries, the superior cerebellar artery was the most common artery (80-90% of cases). The grades of NVC as assessed by MRI included grades I, II, and III with varied proportions in different studies. NVC is a common problem in TN, wherein there is compression at the nerve root entry zone, and it shows a strong predilection for the elderly population. MRI seems to be a novel imaging diagnostic investigation to identify NVC associated with TN. Moreover, NVC grading must be done with MRI so that it may help the surgeon in stratifying the patient\'s treatment.
摘要：
三叉神经痛（TN）是一种使人衰弱的疾病，情节,单侧刺伤面部疼痛令人不安，足以扰乱日常生活活动。经典TN是由于动脉或静脉引起的三叉神经在水箱段的压迫性损伤引起的，称为神经血管接触或冲突（NVC）。磁共振成像（MRI）已成为诊断NVC的标准工具。本研究旨在确定TN中NVC的发生率，如MRI所确定,评估TN患者的各种MRI分级模式，并确定主要涉及NVC的血管。在DOAJ和PubMed/PubMedCentral上对使用MRI参考NVC诊断TN的研究进行了系统搜索。提取数据并输入到MicrosoftExcel电子表格中。测量的结果是MRI显示的NVC发生率，涉及NVC的船只，和MRI分级模式。我们确定并选择了20项符合纳入/排除标准的研究。总的来说,1,436例患者被纳入所有纳入的研究。使用的MRI类型为1.5T或3TMRI。患者的平均年龄从49岁到63岁不等，男女比例相等。同侧1,436例TN中1,276例(88.85%)出现NVC,如MRI所示。在80-90％的病例中，涉及的血管是动脉，其次是静脉。在动脉中，小脑上动脉是最常见的动脉（80-90％）。MRI评估的NVC等级包括I级，II,和III在不同的研究中比例不同。NVC是TN中常见的问题,其中在神经根进入区有压迫，它显示了对老年人的强烈偏好。MRI似乎是一种新颖的影像学诊断研究，可识别与TN相关的NVC。此外，NVC分级必须通过MRI进行，这样可以帮助外科医生对患者的治疗进行分层。
