目的确定无神经血管压迫(NVC)的三叉神经痛(TN)患者岩脊及三叉神经的解剖特点。
2017年5月至2021年3月,66名患者(49名女性,17名男性;平均年龄±标准差[SD],56.8±13.3年),无NVC的TN和57名对照(46名女性和11名男性;52.0±15.6年)。使用高分辨率三维T2序列的磁共振成像测量岩脊(APR)的角度和三叉神经(ATN)的角度。将有症状侧的数据与患者无症状侧的数据以及对照双侧的平均测量值进行比较。进行了受试者工作特征(ROC)分析,以评估APR和ATN在区分TN患者与对照组方面的表现。
在没有NVC的TN患者中,有症状侧APR的平均值±标准差(SD)(98.40°±19.75°)明显小于无症状侧(105.59°±22.45°,p=0.019)和控制(108.44°±15.98°,p=0.003)。有症状侧的平均ATN±SD(144.41°±8.92°)明显小于无症状侧的平均ATN±SD(149.67°±8.09°,p=0.003)和控制(150.45°±8.48°,p=0.001)。区分TN患者与对照组的ROC曲线下面积为APR为0.673(95%置信区间[CI]:0.579-0.758),ATN为0.700(CI:0.607-0.782)。使用诊断截止值产生最高Youden指数的敏感性和特异性分别为81.8%(54/66)和49.1%(28/57),分别,APR(截止分数为94.30°)和65.2%(43/66)和66.7%(38/57),分别,对于ATN(截止分数,148.25°)。
在没有NVC的TN患者中,APR和ATN比对照组小,这可以解释TN的潜在原因,并为诊断提供额外的信息。
To determine the anatomical characteristics of the petrous ridge and trigeminal nerve in trigeminal neuralgia (TN) without neurovascular compression (NVC).
From May 2017 to March 2021, 66 patients (49 female and 17 male; mean age ± standard deviation [SD], 56.8 ± 13.3 years) with TN without NVC and 57 controls (46 female and 11 male; 52.0 ± 15.6 years) were enrolled. The angle of the petrous ridge (APR) and angle of the trigeminal nerve (ATN) were measured using magnetic resonance imaging with a high-resolution three-dimensional T2 sequence. Data on the symptomatic side were compared with those on the asymptomatic side in patients and with the mean measurements of the bilateral sides in controls. Receiver operating characteristic (ROC) analysis was conducted to evaluate the performance of APR and ATN in distinguishing TN patients from controls.
In TN patients without NVC, the mean ± standard deviation (SD) of APR on the symptomatic side (98.40° ± 19.75°) was significantly smaller than that of the asymptomatic side (105.59° ± 22.45°, p = 0.019) and controls (108.44° ± 15.98°, p = 0.003). The mean ATN ± SD on the symptomatic side (144.41° ± 8.92°) was significantly smaller than that of the asymptomatic side (149.67° ± 8.09°, p = 0.003) and controls (150.45° ± 8.48°, p = 0.001). The area under the ROC curve for distinguishing TN patients from controls was 0.673 (95% confidence interval [CI]: 0.579-0.758) for APR and 0.700 (CI: 0.607-0.782) for ATN. The sensitivity and specificity using the diagnostic cutoff yielding the highest Youden index were 81.8% (54/66) and 49.1% (28/57), respectively, for APR (with a cutoff score of 94.30°) and 65.2% (43/66) and 66.7% (38/57), respectively, for ATN (cutoff score, 148.25°).
In patients with TN without NVC, APR and ATN were smaller than those in controls, which may explain the potential cause of TN and provide additional information for diagnosis.