Magnetic resonance neurography of the head and neck: state of the art, anatomy, pathology and future perspectives

Cruyssen, Fréderic Van der; Croonenborghs, Tomas‐Marijn; Renton, Tara; Hermans, Robert; Politis, Constantinus; Jacobs, Reinhilde

doi:10.1259/bjr.20200798

Cited by 14 publications

(10 citation statements)

References 71 publications

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“…Further refinement of this MRI protocol and possible application in MR neurography using high-field-strength MRI could allow the differentiation of the skull base from extracranial nerve segments in T2-weighted images with high soft tissue contrast and homogenous fat, arterial, and venous suppression. This accurate visualization might be useful in various other surgical procedures, such as dental implant placement, mandibular split osteotomy, or detection of post-traumatic trigeminal lesions [ 31 , 32 ]. Therefore, MRI imaging might provide benefits for the patient and the clinician in challenging cases.…”

Section: Discussionmentioning

confidence: 99%

Preoperative visualization of the lingual nerve by 3D double-echo steady-state MRI in surgical third molar extraction treatment

et al. 2021

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Objectives To assess the lingual nerve (LN) visualization using a 3D double-echo steady-state MRI sequence (3D-DESS). Materials and methods Three readers prospectively evaluated the LN for its continuous visibility in 3D-DESS MRI in 19 patients with an indication for removal of mandibular impacted third molars, using a 5-point scale (4 = excellent to 0 = none). Six LN anatomical intermediate points (IP) were selected and checked for their detectability by a 4-point scale (4 = yes to1 = no). Inter- and intra-rater agreement was evaluated using intraclass correlation coefficient and percentage of agreement. Results The average nerve continuity score was 3.3 ± 0.46. In 35% of the cases, the entire course was continuously visible. In 10%, the proximal and 60%, the distal part of the nerve was not continuously visible. Inter- and intra-reader agreement was good (ICC = 0.76, ICC = 0.75). The average detectability score of all IP was 3.7 ± 0.41. From IP1 to IP5, the detectability was excellent; meanwhile, IP6 had lower visibility. The inter- and intra-reader percentage of agreement was 77% and 87%. Conclusions The 3D-DESS sequence allowed accurate and continuous visualization of the LN with high reproducibility in more than one-third of the patients. This could improve the preoperative clarification of the LN position and thereby reduce complications during dentoalveolar surgical interventions. Clinical relevance 3D-DESS MRI might be beneficial in clinical scenarios where the second molar is elongated or presents a difficult rotational position while simultaneously having a close positional relationship to the third molar. Thereby, osteotomy performed more lingually, indicating extended lingual flap detachment may increase the risk of LN damage.

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Section: Discussionmentioning

confidence: 99%

Preoperative visualization of the lingual nerve by 3D double-echo steady-state MRI in surgical third molar extraction treatment

et al. 2021

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“…Imaging was performed on a 3.0-Tesla (T) MRI system (Ingenia; Philips) equipped with 32 channel head coil (INVIVO). A previously published MR neurography sequence, 3D CRANI, was performed [1,8]. 3D CRANI is a 3D TSE STIR sequence that uses a PSS (pseudo-steady state) sweep in combination with MSDE (Motion Sensitized Driven Equilibrium) Pulse.…”

Section: Mri Imaging Proceduresmentioning

confidence: 99%

“…MR neurography (MRN) in the head and neck region is attracting increasing attention in the literature [1]. This novel MRI technique already showed promise to diagnose peripheral and trigeminal neuropathies [2][3][4].…”

Section: Introductionmentioning

confidence: 99%

3D CRANI, a novel MR neurography sequence, can reliable visualise the extraforaminal cranial and occipital nerves

et al. 2022

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Objectives We aim to validate 3D CRANI, a novel high-field STIR TSE, MR neurography sequence in the visualisation of the extraforaminal cranial and occipital nerve branches on a 3-T system. Furthermore, we wish to evaluate the role of gadolinium administration and calculate nerve benchmark values for future reference. Methods Eleven consecutive patients underwent MR imaging including the 3D CRANI sequence before and immediately after intravenous gadolinium administration. Two observers rated suppression quality and nerve visualisation using Likert scales before and after contrast administration. Extraforaminal cranial and occipital nerves were assessed. Nerve calibers and signal intensities were measured at predefined anatomical landmarks, and apparent signal intensity ratios were calculated. Results The assessed segments of the cranial and occipital nerves could be identified in most cases. The overall intrarater agreement was 79.2% and interrater agreement was 82.7% (intrarater κ = .561, p < .0001; interrater κ = .642, p < .0001). After contrast administration, this significantly improved to an intrarater agreement of 92.7% and interrater agreement of 93.6% (intrarater κ = .688, p < .0001; interrater κ = .727, p < .0001). Contrast administration improved suppression quality and significant changes in nerve caliber and signal intensity measurements. Nerve diameter and signal intensity benchmarking values were obtained. Conclusion 3D CRANI is reliable for the visualization of the extraforaminal cranial and occipital nerves. Intravenous gadolinium significantly improves MR neurography when applying this sequence. Benchmarking data are published to allow future assessment of the 3D CRANI sequence in patients with pathology of the extraforaminal cranial and occipital nerves. Key Points • MR neurography using the 3D CRANI sequence is a reliable method to evaluate the extraforaminal cranial and occipital nerves. • Gadolinium contrast administration significantly improves suppression quality and nerve visualisation. • Benchmarking values including apparent signal intensity ratios and nerve calibers depend on contrast administration and might play an important role in future studies evaluating extraforaminal cranial and occipital neuropathies.

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“…The 3D CRANI is a black-blood 3D STIR TSE sequence that uses pseudo steady-state (PSS) sweep in combination with a motion-sensitized driven equilibrium (MSDE) pulse. 19 The combination of MSDE and STIR enables better fat suppression and reduces signal from muscle, and blood across the FOV. Additionally, the PSS sweep is designed to keep the signal strength constant.…”

Section: Three-dimensional Cranial Nerve Imagingmentioning

confidence: 99%

Technical Update on MR Neurography

Martín-Noguerol

Montesinos

Hassankhani

et al. 2022

Semin Musculoskelet Radiol

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Imaging evaluation of peripheral nerves (PNs) is challenging. Magnetic resonance imaging (MRI) and ultrasonography are the modalities of choice in the imaging assessment of PNs. Both conventional MRI pulse sequences and advanced techniques have important roles. Routine MR sequences are the workhorse, with the main goal to provide superb anatomical definition and identify focal or diffuse nerve T2 signal abnormalities. Selective techniques, such as three-dimensional (3D) cranial nerve imaging (CRANI) or 3D NerveVIEW, allow for a more detailed evaluation of normal and pathologic states. These conventional pulse sequences have a limited role in the comprehensive assessment of pathophysiologic and ultrastructural abnormalities of PNs. Advanced functional MR neurography sequences, such as diffusion tensor imaging tractography or T2 mapping, provide useful and robust quantitative parameters that can be useful in the assessment of PNs on a microscopic level. This article offers an overview of various technical parameters, pulse sequences, and protocols available in the imaging of PNs and provides tips on avoiding potential pitfalls.

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Magnetic resonance neurography of the head and neck: state of the art, anatomy, pathology and future perspectives

Cited by 14 publications

References 71 publications

Preoperative visualization of the lingual nerve by 3D double-echo steady-state MRI in surgical third molar extraction treatment

Preoperative visualization of the lingual nerve by 3D double-echo steady-state MRI in surgical third molar extraction treatment

3D CRANI, a novel MR neurography sequence, can reliable visualise the extraforaminal cranial and occipital nerves

Technical Update on MR Neurography

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