Preoperative Assessment of Trigeminal Neuralgia and Hemifacial Spasm Using Constructive Interference in Steady State-Three-dimensional Fourier Transformation Magnetic Resonance Imaging

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概要

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• Results of microvascular decompression(MVD)for trigeminal neuralgia(TN)and hemifacial spasm(HFS)may be improved by accurate preoperative assessment of neurovascular relationships at the root entry/exit zone(REZ). Constructive interference in steady state(CISS)-three-dimensional Fourier transformation(3DFT)magnetic resonance(MR)imaging was evaluated for visualizing the neurovascular relationships at the REZ. Fourteen patients with TN and eight patients with HFS underwent MR imaging using CISS-3DFT and 3D fast inflow with steady-state precession(FISP)sequences. Axial images of the cerebellopontine angle(CPA) obtained by the two sequences were reviewed to assess the neurovascular relationships at the REZ of the trigeminal and facial nerves. Eleven patients subsequently underwent MVD. Preoperative MR imaging findings were related to surgical observations and results. CISS MR imaging provided excellent contrast between the cranial nerves, small vessels, and cerebrospinal fluid(CSF)in the CPA. CISS was significantly better than FISP for delineating anatomic detail in the CPA(trigeminal and facial nerves, petrosal vein)and abnormal neurovascular relationships responsible for TN and HFS(vascular contact and deformity at the REZ). Preoperative CISS MR imaging demonstrated precisely the neurovascular relationships at the REZ and identified the offending artery in all seven patients with TN undergoing MVD. CISS MR imaging has high resolution and excellent contrast between cranial nerves, small vessels, and CSF, so can precisely and accurately delineate normal and abnormal neurovascular relationships at the REZ in the CPA, and is a valuable preoperative examination for MVD.

• 日本脳神経外科学会の論文
• 2000-11-15

著者

• Hirai Shinji

  Department Of Thoracic And Cardiovascular Surgery Hiroshima Prefectural Hospital

• Hirai Shinji

  Department Of Internal Medicine Hitachi General Hospital

• Yamaura Akira

  Department Of Neurosurgery Chiba University School Of Medicine

• Yamaura Akira

  Department Of Neurological Surgery Chiba University School Of Medicine

• Yamaura Akira

  Japan Neurotrauma Data Bank (jntdb) Committee:japan Society Of Neurotraumatology The Japanese Counci

• YAMAKAMI Iwao

  Department of Neurosurgery, Chiba University School of Medicine, Chiba

• KOBAYASHI Eiichi

  Department of Neurosurgery, Chiba University School of Medicine, Chiba

• 山上 岩男

  千葉大学医学研究院脳神経外科学

• Yamakami Iwao

  Department Of Neurosurgery Chiba University School Of Medicine

• Kobayashi Eiichi

  Department Of Neurosurgery Chiba University School Of Medicine

• Hirai Shinji

  Department Of Neurosurgery Chiba University School Of Medicine

• Hirai Shinji

  Department Of Clinical Research National Shimofusa Hospital

• Yamaura Akira

  Department Of Neurological Surgery

• 山上 岩男

  千葉大学 大学院医学研究院 脳神経外科

• YAMAURA Akira

  Chiba University Graduate School of Medicine

• KOBAYASHI Eiichi

  Chiba University Graduate School of Medicine

• Yamakami Iwao

  Department Of Neurosurgery Chiba University Graduate School Of Medicine

• Kobayashi Eiichi

  Department Of Industrial Chemistry Faculty Of Science And Technology Science University Of Tokyo

• HIRAI Shinji

  Department of Cardiovascular and Respiratory Surgery, Hiroshima Prefectural Hospital

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