METHODS: 57 PTN patients who underwent microvascular decompression (MVD) or percutaneous balloon compression (PBC) surgery in Hebei general hospital between January 2020 and April 2023 were included. Additionally, 30 patients with facial spasms(HFS) were included as a control group. All patients underwent 3D-TOF-MRA and 3D-FIESTA sequence examinations. Comparisons of bilateral trigeminal nerve volumes within and between groups were conducted by performing image fusion using 3D-slicer.
RESULTS: The volume of the affected trigeminal nerve in the MVD group (33.96 mm³±12.61 mm³) and PBC group (23.05 mm³±7.71 mm³) was smaller than that of the unaffected trigeminal nerve in the MVD group (39.61 mm³±12.83 mm³) and PBC group (26.14 mm³±6.42 mm³), as well as the average volume of the trigeminal nerve in the control group (40.27 mm³±10.25 mm³) (P<0.05). The differences in bilateral trigeminal ganglion volume (∆V) was significant between the MVD group (∆V=23.59 %±14.32 %) and the control group (∆V=14.64 %±10.00 %) (P<0.05). There was no statistical difference in the trigeminal nerve volume difference between the MVD group (∆V=23.59 %±14.32 %) and the PBC group (∆V=26.52 %±15.00 %) (P>0.05).
CONCLUSIONS: Trigeminal nerve atrophy is correlated with primary trigeminal neuralgia. 3D-slicer software can quantitatively measure trigeminal nerve volume and assist in the diagnosis of primary trigeminal neuralgia based on the difference in bilateral trigeminal nerve volumes. However, trigeminal nerve atrophy is not associated with postoperative pain recurrence in patients.
方法:纳入2020年1月至2023年4月在河北省总医院行微血管减压术(MVD)或经皮球囊压迫术(PBC)的57例PTN患者。此外,30例面部痉挛(HFS)患者作为对照组。所有患者均行3D-TOF-MRA和3D-FIESTA序列检查。通过使用3D切片机进行图像融合,比较了组内和组间的双侧三叉神经体积。
结果:MVD组(33.96mm2001±12.61mmm3)和PBC组(23.05mmm3±7.71mmm3)的受影响三叉神经的体积小于MVD组(39.61mmm3±12.83mmm3)和PBC组(26.14mm±6.42mm)的未受影响三叉神经的体积,以及对照组的三叉神经平均体积(40.27mmpa±10.25mmpa)(P<0.05)。双侧三叉神经节体积(ΔV)在MVD组(ΔV=23.59%±14.32%)与对照组(ΔV=14.64%±10.00%)之间差异有统计学意义(P<0.05)。MVD组(ΔV=23.59%±14.32%)与PBC组(ΔV=26.52%±15.00%)的三叉神经容积差异无统计学意义(P>0.05)。
结论:三叉神经萎缩与原发性三叉神经痛有关。3D-slicer软件可以定量测量三叉神经体积,并根据双侧三叉神经体积的差异辅助诊断原发性三叉神经痛。然而,三叉神经萎缩与患者术后疼痛复发无关。