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The aim of this study was to investigate the accuracy of sonography and magnetic resonance imaging (MRI) in assessing trigeminal neuralgia-related small focal intradural rootlets using Mallet criteria. Data were retrospectively analyzed for the presence or absence of intradural rootlets in 38 patients who had undergone both sonography and MRI. The patients had undergone microvascular decompression surgery for the treatment of idiopathic trigeminal neuralgia. The sensitivities, specificities, positive likelihood ratios (PLR) and negative likelihood ratios (NLR), positive and negative predictive values, and diagnostic accuracy for each method were calculated. The sensitivity of sonography for the detection of intradural rootlets was significantly higher than that of MRI (95.3% vs 71.0%, P = 0.003), and the specificity of sonography was significantly lower (62.0% vs 95.5%, P = 0.003). The PLR of MRI was higher than that of sonography (2.54 vs 1.65). The NLR of sonography was higher than that of MRI (0.22 vs 0.32). The PPV of sonography was significantly lower than that of MRI (42.5% vs 88.7%, P = 0.001), and the NPV of sonography was higher than that of MRI (98.1% vs 89.2%, P = 0.008).
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