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

This article focuses on a prospective comparison of two magnetic resonance (MR) cisternography sequences—Constructive Interference in Steady State (CISS) and Sampling Perfection with Application-optimized Contrasts using different flip angle Evolutions (SPACE)—for diagnosing trigeminal neuralgia (TN) using 3-Tesla MRI. In a study of 60 patients with clinically diagnosed or suspected TN, SPACE demonstrated superior image quality, including higher contrast between the trigeminal nerve (cranial nerve V, CN5) and cerebrospinal fluid (CSF), better visibility of CN5 and the basilar artery, fewer artefacts, and more homogeneous CSF depiction compared to CISS. These findings suggest that SPACE, a 3D fast spin echo-based technique, provides clearer visualization of CN5 and prepontine cistern vascularity, making it a valuable sequence for TN diagnosis. The study notes limitations in assessing diagnostic accuracy due to the small number of confirmed TN cases and recommends further research with larger cohorts.