MR cisternography for trigeminal neuralgia: comparison between gradient-echo and spin echo 3D sequences

Area of Science:

• Radiology
• Medical Imaging
• Neurology

Background:

• Trigeminal neuralgia (TN) is a debilitating condition affecting cranial nerve V.
• Accurate diagnosis relies on high-resolution imaging of the trigeminal nerve and surrounding structures.
• Comparing different MRI sequences is crucial for optimizing diagnostic protocols.

Purpose of the Study:

• To quantitatively and qualitatively compare two 3-T MRI cisternography sequences: CISS and SPACE.
• To determine the optimal MRI sequence for diagnosing trigeminal neuralgia.
• To evaluate the diagnostic performance of SPACE versus CISS in visualizing cranial nerve V and vascularity.

Main Methods:

• Prospective study of 64 patients with suspected or diagnosed TN.
• Acquisition of 3-T MRI scans using both CISS and SPACE sequences.
• Quantitative analysis of signal intensity for cranial nerve V, CSF, and contrast.
• Qualitative assessment of basilar artery, cranial nerve V, CSF, artifacts, and overall image quality by radiologists.

Main Results:

• SPACE sequences demonstrated significantly higher contrast between cranial nerve V and CSF (P < .001).
• SPACE provided superior visualization of cranial nerve V and basilar artery compared to CISS (P < .001).
• SPACE sequences resulted in significantly better overall image quality and fewer artifacts (P < .001).

Conclusions:

• Sampling Perfection with Application-optimized Contrasts (SPACE) sequences yield superior image quality for trigeminal neuralgia diagnosis.
• SPACE offers better evaluation of cranial nerve V and prepontine cistern vascularity than CISS.
• SPACE is recommended as the preferred MRI sequence for diagnosing trigeminal neuralgia.