Trigeminal nevraljili hastalarda hematolojik inflamasyon parametrelerinin ve kranial manyetik rezonans görüntüleme bulgularının değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, trigeminal nevralji (TN) ile lökosit bazlı inflamatuar indeksler de dahil olmak üzere hematolojik parametreler arasındaki ilişkiyi değerlendirmek ve bunların kranial manyetik rezonans görüntüleme (MRI) bulgularıyla ilişkisini araştırmaktır. Yöntemler: Yeni tanı almış TN'li 114 hasta ve benzer demografik özelliklere sahip 114 sağlıklı kontrol grubu üzerinde retrospektif bir analiz yürütüldü. Klinik, laboratuvar ve kranial MRI verileri hastane kayıtlarından toplandı. Kranial MRI ile beyaz cevher anormallikleri belirlendi ve inflamatuar indeksler şu şekilde hesaplandı: nötrofil-lenfosit oranı (NLR) = nötrofil sayısı / lenfosit sayısı, trombosit-lenfosit oranı (PLR = trombosit sayısı / lenfosit sayısı, sistemik immün-inflamasyon indeksi (SII) = trombosit sayısı × nötrofil sayısı / lenfosit sayısı ve sistemik inflamatuar yanıt indeksi (SIRI) = nötrofil sayısı × monosit sayısı / lenfosit sayısı. Sonuçlar: TN hastalarında önemli ölçüde daha yüksek lökosit sayısı (7,4 ± 1,8 - 6,0 ± 1,9 ×10³/μL, p < 0,001), nötrofil sayısı (4,2 ± 1,1 - 2,8 ± 0,8 ×10³/μL, p < 0,001) görüldü. CRP düzeyleri (ortanca: 2,6 - 0,8 mg/dL, p < 0,001) ve inflamasyon indeksleri (NLR, PLR, SII ve SIRI; hepsi için p < 0,001) kontrol grubuyla karşılaştırıldı. Beyaz cevher anormallikleri TN hastalarının %16,7'sinde, ağırlıklı olarak frontal (%11,4) ve parieto-oksipital (%7,0) bölgelerde tespit edildi. Beyaz cevher anormallikleri olan hastalar, olmayanlara göre önemli ölçüde daha yüksek inflamasyon indeksleri sergiledi. Diğer inflamasyon parametreleriyle karşılaştırıldığında, SIRI TN (eşik: 0,7; duyarlılık: %84,2, özgüllük: %82,5) ve beyaz cevher anormallikleri (eşik: 1,3; duyarlılık: %78,9, özgüllük: %82,1) için en yüksek tanı performansını gösterdi. Sonuç: İnflamasyon belirteçleri, özellikle SIRI, TN hastalarında önemli ölçüde yüksektir ve beyaz cevher anormallikleri ile ilişkilidir. Bu belirteçler, TN ve ilgili MRI bulgularını tahmin etmede yararlı non-invaziv araçlar olarak hizmet edebilir.

Keywords

• Trigeminal nevralji
• inflamasyon belirteçleri
• beyaz cevher lezyonları
• kranial MRI
• inflamasyon indeksi

Evaluation of hematologic inflammation parameters and cranial magnetic resonance imaging findings in patients with trigeminal neuralgia

Abstract

Aims: This study aimed to evaluate the relationship between trigeminal neuralgia (TN) and hematological parameters, including leukocyte-based inflammatory indices, and to explore their association with cranial magnetic resonance imaging (MRI) findings. Methods: A retrospective analysis was conducted on 114 patients with newly diagnosed TN and 114 healthy control groups with comparable demographic characteristics. Clinical, laboratory, and cranial MRI data were collected from hospital records. White matter abnormalities were identified via cranial MRI, and inflammatory indices were calculated as follows: neutrophil-to-lymphocyte ratio (NLR)=Neutrophil count/lymphocyte count, platelet-to-lymphocyte ratio (PLR)=Platelet count/lymphocyte count, Systemic Immune-Inflammation Index (SII)=Platelet count×neutrophil count/lymphocyte count, and Systemic Inflammatory Response Index (SIRI)=Neutrophil count×monocyte count/lymphocyte count. Results: TN patients showed significantly higher leukocyte counts (7.4±1.8 vs. 6.0±1.9 ×10³/μl, p<0.001), neutrophil counts (4.2±1.1 vs. 2.8±0.8×10³/μl, p<0.001), CRP levels (median: 2.6 vs. 0.8 mg/dl, p<0.001), and inflammatory indices (NLR, PLR, SII, and SIRI; p<0.001 for all) compared to control group. White matter abnormalities were detected in 16.7% of TN patients, predominantly in the frontal (11.4%) and parieto-occipital (7.0%) regions. Patients with white matter abnormalities exhibited significantly higher inflammatory indices than those without. Compared to other inflammatory parameters, SIRI demonstrated the highest diagnostic performance for TN (threshold: 0.7; sensitivity: 84.2%, specificity: 82.5%) and white matter abnormalities (threshold: 1.3; sensitivity: 78.9%, specificity: 82.1%). Conclusion: Inflammatory markers, particularly SIRI, are significantly elevated in TN patients and are associated with white matter abnormalities. These markers may serve as useful non-invasive tools for predicting TN and related MRI findings.

Keywords

• Trigeminal neuralgia
• inflammation markers
• white matter lesions
• cranial MRI
• Inflammation Index

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