The Diagnostic Value of Magnetic Resonance Imaging in Posttraumatic Trigeminal Neuropathic Pain.

IF 1.9 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral & Facial Pain and Headache Pub Date : 2021-12-01 DOI:10.11607/ofph.2732

Frederik Peeters, Fréderic Van der Cruyssen, Jan W Casselman, Robert Hermans, Tara Renton, Reinhilde Jacobs, Constantinus Politis

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引用次数: 2

Abstract

Aims: To evaluate the diagnostic value of non-nerve-selective MRI sequences in posttraumatic trigeminal neuropathic pain (PTNP).

Methods: This study retrospectively analyzed all MRI protocols performed between February 2, 2012 and June 20, 2018 commissioned by the Department of Oral and Maxillofacial Surgery, University Hospitals Leuven. Demographic, clinical, and radiologic data were extracted from the records of patients with an MRI in the context of PTNP. A contingency table was constructed based on the opinions of the treating physician and the radiologist who initially evaluated the MRI. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated.

Results: The sample consisted of 27 women (65.9%) and 14 men (34.1%). The sensitivity and negative predictive value of MRI in PTNP were 0.18 and 0.77, respectively. Artifacts interfered with visualization of a possible cause of the trigeminal pain in 24.4% of MRIs. Almost all artifacts (90%) were caused by metal debris originating from the causal procedure or posttraumatic surgeries. MRI resulted in changed management for PTNP patients only once.

Conclusion: The diagnostic value of non-nerve-selective MRI sequences for PTNP is low and has little impact on clinical management. Therefore, there is a need for dedicated sequences with high resolution and low artifact susceptibility for visualizing the posttraumatic injuries of the trigeminal branches.

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磁共振成像对创伤后三叉神经性疼痛的诊断价值。

目的:探讨非神经选择性MRI序列对创伤后三叉神经性疼痛(PTNP)的诊断价值。方法:本研究回顾性分析了鲁汶大学医院口腔颌面外科委托于2012年2月2日至2018年6月20日进行的所有MRI协议。从PTNP患者的MRI记录中提取人口统计学、临床和放射学数据。根据治疗医师和最初评估MRI的放射科医生的意见，建立了一个应急表。计算敏感性、特异性、阳性预测值和阴性预测值。结果:女性27例(65.9%)，男性14例(34.1%)。MRI对PTNP的敏感性为0.18，阴性预测值为0.77。在24.4%的mri中，伪影干扰了三叉神经疼痛的可能原因的可视化。几乎所有假物(90%)都是由因果手术或创伤后手术产生的金属碎片引起的。MRI仅改变了一次PTNP患者的治疗方法。结论:非神经选择性MRI序列对PTNP的诊断价值较低，对临床治疗影响不大。因此，需要高分辨率和低伪影敏感性的专用序列来显示创伤后三叉分支的损伤。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Oral & Facial Pain and Headache DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

5.10

自引率

4.00%

发文量

期刊介绍： Founded upon sound scientific principles, this journal continues to make important contributions that strongly influence the work of dental and medical professionals involved in treating oral and facial pain, including temporomandibular disorders, and headache. In addition to providing timely scientific research and clinical articles, the journal presents diagnostic techniques and treatment therapies for oral and facial pain, headache, mandibular dysfunction, and occlusion and covers pharmacology, physical therapy, surgery, and other pain-management methods.