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Gaudino C, Cassoni A, Pisciotti ML, Pucci R, Palma A, Fantoni N, Pantano P, Valentini V. MR-Neurography of the facial nerve in parotid tumors: intra-parotid nerve visualization and surgical correlation. Neuroradiology 2024:10.1007/s00234-024-03372-5. [PMID: 38714544 DOI: 10.1007/s00234-024-03372-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 05/01/2024] [Indexed: 05/10/2024]
Abstract
PURPOSE One of the most severe complications in surgery of parotid tumors is facial palsy. Imaging of the intra-parotid facial nerve is challenging due to small dimensions. Our aim was to assess, in patients with parotid tumors, the ability of high-resolution 3D double-echo steady-state sequence with water excitation (DE3D-WE) (1) to visualize the extracranial facial nerve and its tracts, (2) to evaluate their relationship to the parotid lesion and (3) to compare MRI and surgical findings. METHODS A retrospective study was conducted including all patients with parotid tumors, who underwent MRI from April 2022 to December 2023. Two radiologists independently reviewed DE3D-WE images, assessing quality of visualization of the facial nerve bilaterally and localizing the nerve's divisions in relation to the tumor. MRI data were compared with surgical findings. RESULTS Forty consecutive patients were included (M:F = 22:18; mean age 56.3 ± 17.4 years). DE3D-WE could excellently visualize the nerve main trunk and the temporofacial division in all cases. The cervicofacial branch was visible in 99% of cases and visibility was good. Distal divisions were displayed in 34% of cases with a higher visibility on the tumor side (p < 0.05). Interrater agreement was high (weighted kappa 0.94 ± 0.01 [95% CI 0.92-0.97]). Compared to surgery accuracy of MRI in localizing the nerve was 100% for the main trunk, 96% for the temporofacial and 89% for the cervicofacial branches. CONCLUSIONS Facial nerve MR-neurography represents a reliable tool. DE3D-WE can play an important role in surgical planning of patients with parotid tumors, reducing the risk of nerve injury.
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Affiliation(s)
- Chiara Gaudino
- Department of Neuroradiology, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Viale del Policlinico 155, 00161, -Rome, Italy.
| | - Andrea Cassoni
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161, Rome, Italy
- Department of Maxillo-Facial Surgery, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy
| | - Martina Lucia Pisciotti
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00180, Rome, Italy
| | - Resi Pucci
- Department of Maxillo-Facial Surgery, Azienda Ospedaliera San Camillo Forlanini, Circonvallazione Gianicolense 87, 00152, Rome, Italy
| | - Angela Palma
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161, Rome, Italy
| | - Nicoletta Fantoni
- Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Viale Regina Elena 324, 00180, Rome, Italy
| | - Patrizia Pantano
- Department of Neuroradiology, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Viale del Policlinico 155, 00161, -Rome, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Viale Dell'Università 30, 00185, -Rome, Italy
- IRCCS Neuromed, Via Atinense 18, 86077, Pozzilli, IS, Italy
| | - Valentino Valentini
- Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome, Via Caserta 6, 00161, Rome, Italy
- Department of Maxillo-Facial Surgery, Azienda Ospedaliero-Universitaria Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy
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Hu LH, Yu Y, Tang ZN, Sun ZP, Yang C, Yu GY, Zhang WB, Peng X. Direct visualization of intraparotid facial nerve assisting in parotid tumor resection. J Craniomaxillofac Surg 2024; 52:659-665. [PMID: 38580555 DOI: 10.1016/j.jcms.2024.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 03/12/2024] [Indexed: 04/07/2024] Open
Abstract
Precise recognition of the intraparotid facial nerve (IFN) is crucial during parotid tumor resection. We aimed to explore the application effect of direct visualization of the IFN in parotid tumor resection. Fifteen patients with parotid tumors were enrolled in this study and underwent specific radiological scanning in which the IFNs were displayed as high-intensity images. After image segmentation, IFN could be preoperatively directly visualized. Mixed reality combined with surgical navigation were applied to intraoperatively directly visualize the segmentation results as real-time three-dimensional holograms, guiding the surgeons in IFN dissection and tumor resection. Radiological visibility of the IFN, accuracy of image segmentation and postoperative facial nerve function were analyzed. The trunks of IFN were directly visible in radiological images for all patients. Of 37 landmark points on the IFN, 36 were accurately segmented. Four patients were classified as House-Brackmann Grade I postoperatively. Two patients with malignancies had postoperative long-standing facial paralysis. Direct visualization of IFN was a feasible novel method with high accuracy that could assist in recognition of IFN and therefore potentially improve the treatment outcome of parotid tumor resection.
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Affiliation(s)
- Lei-Hao Hu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Haidian District, Beijing, 100081, China.
| | - Yao Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Haidian District, Beijing, 100081, China.
| | - Zu-Nan Tang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Haidian District, Beijing, 100081, China.
| | - Zhi-Peng Sun
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Haidian District, Beijing, 100081, China.
| | - Cong Yang
- Tsinghua Laboratory of Brain and Intelligence, Tsinghua University, Haidian District, Beijing, 100084, China.
| | - Guang-Yan Yu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Haidian District, Beijing, 100081, China.
| | - Wen-Bo Zhang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Haidian District, Beijing, 100081, China.
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Haidian District, Beijing, 100081, China.
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Barry B, Verillaud B, Jegoux F, Pham Dang N, Baujat B, Chabrillac E, Vergez S, Fakhry N. Surgery of major salivary gland cancers: REFCOR recommendations by the formal consensus method. Eur Ann Otorhinolaryngol Head Neck Dis 2024; 141:153-160. [PMID: 38040591 DOI: 10.1016/j.anorl.2023.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
OBJECTIVE To determine the role of surgery of the primary tumor site in the management of primary major salivary gland cancer. MATERIAL AND METHODS The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group, which drafted a non-systematic narrative review of the literature published on Medline, and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group, according to the formal consensus method. RESULTS Treatment of salivary gland tumor is mainly surgical. The gold standard for parotid cancer is a total parotidectomy, to obtain clear margins and remove all intraparotid lymph nodes. For low-grade tumors, partial parotidectomy with wide excision of the tumor is acceptable in the case of postoperative diagnosis on definitive histology. In the event of positive margins on definitive analysis, revision surgery should be assessed for feasibility, and performed if possible. CONCLUSION Treatment of primary major salivary gland cancer is based on surgery with clear resection margins, as far away as possible from the tumor. The type of surgery depends on tumor location, pathologic type and extension.
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Affiliation(s)
- B Barry
- Département d'ORL et Chirurgie Cervico-Faciale, Hôpital Bichat, AP-HP, Paris, France
| | - B Verillaud
- Département d'ORL et de Chirurgie Cervico-Faciale, Inserm U1141, Hôpital Lariboisière, AP-HP, Université Paris Cité, Paris, France
| | - F Jegoux
- Département d'ORL et Chirurgie Cervico-Faciale, CHU de Rennes, Rennes, France
| | - N Pham Dang
- Service de Chirurgie Maxillo-Faciale, Inserm, Neuro-Dol, Université Clermont Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - B Baujat
- Département d'ORL et Chirurgie Cervico-Faciale, Hôpital Tenon, AP-HP, Sorbonne Université, Paris, France
| | - E Chabrillac
- Département de Chirurgie, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France
| | - S Vergez
- Département de Chirurgie, Institut Universitaire du Cancer Toulouse - Oncopole, Toulouse, France; Département de Chirurgie ORL et Cervico-Faciale, CHU Toulouse-Larrey, Université Toulouse III Paul-Sabatier, Toulouse, France
| | - N Fakhry
- Service d'ORL et Chirurgie Cervico-Faciale, Hôpital La Conception, AP-HM, 147, boulevard Baille, 13005 Marseille, France.
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Pitman J, Lin Y, Tan ET, Sneag D. Magnetic Resonance Neurography of the Lumbosacral Plexus. Radiol Clin North Am 2024; 62:229-245. [PMID: 38272617 DOI: 10.1016/j.rcl.2023.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
Pain and weakness in the low back, pelvis, and lower extremities are diagnostically challenging, and imaging can be an important step in the workup and management of these patients. Technical advances in magnetic resonance neurography (MRN) have significantly improved its utility for imaging the lumbosacral plexus (LSP). In this article, the authors review LSP anatomy and selected pathology examples. In addition, the authors will discuss technical considerations for MRN with specific points for the branch nerves off the plexus.
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Affiliation(s)
- Jenifer Pitman
- Musculoskeletal Imaging, Department of Radiology, Johns Hopkins Hospital, 601 N Caroline Street, 3rd Floor, Baltimore, MD, USA.
| | - Yenpo Lin
- Radiology Department, Hospital For Special Surgery, 535 East 70th Street, 3rd Floor, New York, NY, USA; Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ek Tsoon Tan
- Radiology Department, Hospital For Special Surgery, 535 East 70th Street, 3rd Floor, New York, NY, USA
| | - Darryl Sneag
- Radiology Department, Hospital For Special Surgery, 535 East 70th Street, 3rd Floor, New York, NY, USA
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Thierry A, Barbe C, Labrousse M, Makeieff M, Merol JC, Carsin-Vu A, Truong F, Dubernard X, Brenet E. Intra-parotid facial nerve path by MRI tractography: radio-clinical comparison in parotid tumors. Eur Arch Otorhinolaryngol 2024; 281:925-934. [PMID: 37917163 DOI: 10.1007/s00405-023-08301-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 10/17/2023] [Indexed: 11/04/2023]
Abstract
PURPOSE The objective of our study was to evaluate the ability of preoperative MRI tractography to visualize and predict the path of the facial nerve with respect to an intra-parotid mass. METHODS We performed an observational bicentric study from June 2019 to August 2020. All patients older than 18 years old, treated for a parotid mass with surgical indication, without MRI contraindication and who agreed to participate in the study were enrolled prospectively. All patients underwent a cervico-facial MRI with tractographic analysis. Postprocessed tractography images of the intra-parotid facial nerve were analyzed by two expert radiologists in head and neck imaging. The intraoperative anatomical description of the facial nerve path and its relationship to the mass was performed by the surgeon during the operation, with no visibility on MRI examination results. A statistical study allowed for the description of the data collected as well as the measurement of inter-observer agreement and agreement between tractography and surgery using kappa coefficients. RESULTS Fifty-two patients were included. The facial nerve trunk and its first two divisional branches were visualized via tractography in 93.5% of cases (n = 43). The upper distal branches were visualized in 51.1% of cases (n = 23), and the lower branches were visualized in 73.3% of cases (n = 33). Agreement with the location described per-operatively was on average 82.9% for the trunk, 74.15% for the temporal branch, and 75.21% for the cervico-facial branch. CONCLUSION Fiber tractography analysis by MRI of the intra-parotid facial nerve appears to be a good test for predicting the path of the nerve over the parotid mass and could be an additional tool to guide the surgeon in the operative procedure.
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Affiliation(s)
- Axelle Thierry
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Coralie Barbe
- University Department of Health Research, University of Reims Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Marc Labrousse
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Marc Makeieff
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Jean-Claude Merol
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Aline Carsin-Vu
- University Department of Health Research, University of Reims Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - France Truong
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Xavier Dubernard
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France
- University of Reims-Champagne Ardennes, Reims, France
- Department of Radiology, University Hospital of Reims, Reims, France
| | - Esteban Brenet
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, University Hospital of Reims, Reims, France.
- University of Reims-Champagne Ardennes, Reims, France.
- Department of Radiology, University Hospital of Reims, Reims, France.
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Qin Y, Liu J, Zhang X, Fan X, Li G, Chang Y, Li L. To explore the pathogenesis of Bell's palsy using diffusion tensor image. Sci Rep 2023; 13:15298. [PMID: 37714930 PMCID: PMC10504306 DOI: 10.1038/s41598-023-42570-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/12/2023] [Indexed: 09/17/2023] Open
Abstract
To explore the pathogenesis of Bell's palsy using the diffusion tensor image on 3.0 T MR. The healthy people and the patients with Bell's palsy underwent intraparotid facial nerve scanning by using the DTI and T1 structural sequence at 3.0 T MR. The raw DTI data were performed affine transformation and nonlinear registration in the common MNI152_T1 space and resampled to the 0.4 mm3 voxel size. A group of 4 spherical seed regions were placed on the intratemporal facial nerves in the common space, bilaterally and symmetrically. The DTI data in the common space were used to track the intratemporal facial nerve fibers by using TrackVis and its Diffusion Toolkit. Each tractography was used to construct the maximum probability map (MPM) according to the majority rule. The fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) were calculated and extracted on the basis of MPM. For healthy people, there was no significant difference in FA, MD, RD and AD of bilateral facial nerves. For patients with Bell's palsy, there was no significant difference in AD, there was significant difference in FA, MD and RD between the affected nerve and the healthy nerve (P < 0.02). This study showed that the myelin sheath injury of the intratemporal facial nerve is the main cause of Bell's palsy. Most neural axons are not damaged. The results may explain the pathogenesis of the Bell's palsy, which is self-limited for most cases.
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Affiliation(s)
- Yi Qin
- Radiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88, ChangLing Road, XiQing District, Tianjin, 300381, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, ChangLing Road, XiQing District, Tianjin, 300381, China
| | - Jihua Liu
- Radiology Department, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88, ChangLing Road, XiQing District, Tianjin, 300381, China.
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, ChangLing Road, XiQing District, Tianjin, 300381, China.
| | - Xuening Zhang
- Radiology Department, The Second Hospital of Tianjin Medical University, No. 23, Pingjiang Road, He Xi District, Tianjin, 300211, China
| | - Xiaonong Fan
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, ChangLing Road, XiQing District, Tianjin, 300381, China
| | - Guiping Li
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, ChangLing Road, XiQing District, Tianjin, 300381, China
| | - Yinghui Chang
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, ChangLing Road, XiQing District, Tianjin, 300381, China
| | - Li Li
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, No. 88, ChangLing Road, XiQing District, Tianjin, 300381, China
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Jeong HS, Kim Y, Kim HJ, Kim HJ, Kim EH, Woo SY, Chung MK, Son YI. Imaging of Facial Nerve With 3D-DESS-WE-MRI Before Parotidectomy: Impact on Surgical Outcomes. Korean J Radiol 2023; 24:860-870. [PMID: 37634641 PMCID: PMC10462904 DOI: 10.3348/kjr.2022.0850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 04/12/2023] [Accepted: 05/30/2023] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE The intra-parotid facial nerve (FN) can be visualized using three-dimensional double-echo steady-state water-excitation sequence magnetic resonance imaging (3D-DESS-WE-MRI). However, the clinical impact of FN imaging using 3D-DESS-WE-MRI before parotidectomy has not yet been explored. We compared the clinical outcomes of parotidectomy in patients with and without preoperative 3D-DESS-WE-MRI. MATERIALS AND METHODS This prospective, non-randomized, single-institution study included 296 adult patients who underwent parotidectomy for parotid tumors, excluding superficial and mobile tumors. Preoperative evaluation with 3D-DESS-WE-MRI was performed in 122 patients, and not performed in 174 patients. FN visibility and tumor location relative to FN on 3D-DESS-WE-MRI were evaluated in 120 patients. Rates of FN palsy (FNP) and operation times were compared between patients with and without 3D-DESS-WE-MRI; propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to adjust for surgical and tumor factors. RESULTS The main trunk, temporofacial branch, and cervicofacial branch of the intra-parotid FN were identified using 3D-DESS-WE-MRI in approximately 97.5% (117/120), 44.2% (53/120), and 25.0% (30/120) of cases, respectively. The tumor location relative to FN, as assessed on magnetic resonance imaging, concurred with surgical findings in 90.8% (109/120) of cases. Rates of temporary and permanent FNP did not vary between patients with and without 3D-DESS-WE-MRI according to PSM (odds ratio, 2.29 [95% confidence interval {CI} 0.64-8.25] and 2.02 [95% CI: 0.32-12.90], respectively) and IPTW (odds ratio, 1.76 [95% CI: 0.19-16.75] and 1.94 [95% CI: 0.20-18.49], respectively). Conversely, operation time for surgical identification of FN was significantly shorter with 3D-DESS-WE-MRI (median, 25 vs. 35 min for PSM and 25 vs. 30 min for IPTW, P < 0.001). CONCLUSION Preoperative FN imaging with 3D-DESS-WE-MRI facilitated anatomical identification of FN and its relationship to the tumor during parotidectomy. This modality reduced operation time for FN identification, but did not significantly affect postoperative FNP rates.
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Affiliation(s)
- Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Yikyung Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Hyung-Jin Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hak Jung Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Eun-Hye Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Sook-Young Woo
- Center for Biomedical Statistics, Samsung Medical Center, Seoul, Republic of Korea
| | - Man Ki Chung
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young-Ik Son
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Saadya A, Chegini S, Morley S, McGurk M. Augmented reality presentation of the extracranial facial nerve: an innovation in parotid surgery. Br J Oral Maxillofac Surg 2023; 61:428-436. [PMID: 37328316 DOI: 10.1016/j.bjoms.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/12/2023] [Accepted: 05/17/2023] [Indexed: 06/18/2023]
Abstract
Surgeons used to be unaware of the facial nerve's position during parotid surgery. Now, with special magnetic resonance imaging (MRI) sequences, it can be located and converted into a 3D model displayed on an augmented reality (AR) device for surgeons to study and manipulate. This study explores the accuracy and usefulness of the technique for the treatment of benign and malignant parotid tumours. A total of 20 patients with parotid tumours had 3-Tesla MRI scans, and their anatomical structures were segmented using Slicer software. The structures were imported into a Microsoft HoloLens 2® device, displayed in 3D, and shown to the patient for consent. Intraoperative video recording was used to record the position of the facial nerve in relation to the tumour. The predicted path of the nerve taken from the 3D model was combined with surgical observation and video recording in all cases. The imaging proved to have application in both benign and malignant disease. It also improved the process of informed patient consent. Three-dimensional MRI imaging of the facial nerve within the parotid gland and its display in a 3D model is an innovative technique for parotid surgery. Surgeons can now see the nerve's position and tailor their approach to each patient's tumour, providing personalised care. The technique eliminates the surgeon's blind spot and is a significant advantage in parotid surgery.
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Affiliation(s)
- Ahmad Saadya
- University College London Hospital, United Kingdom.
| | | | - Simon Morley
- University College London Hospital, United Kingdom.
| | - Mark McGurk
- University College London Hospital, United Kingdom.
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Al-Haj Husain A, Schmidt V, Valdec S, Stadlinger B, Winklhofer S, Schönegg D, Sommer S, Özcan M, Al-Haj Husain N, Piccirelli M. MR-orthopantomography in operative dentistry and oral and maxillofacial surgery: a proof of concept study. Sci Rep 2023; 13:6228. [PMID: 37069287 PMCID: PMC10110573 DOI: 10.1038/s41598-023-33483-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 04/13/2023] [Indexed: 04/19/2023] Open
Abstract
This prospective study aimed to present, compare, and evaluate the suitability of five different magnetic resonance imaging (MRI) protocols (3D double-echo steady-state (DESS), 3D fast spin echo short-tau inversion recovery (SPACE-STIR), 3D fast spin echo spectral attenuated inversion recovery (SPACE-SPAIR), volumetric interpolated breath-hold examination (T1-VIBE-Dixon), and ultrashort echo time (UTE)) and for orthopantomogram (OPG)-like MRI reconstructions using a novel mandibular coil. Three readers assessed MR-OPGs of 21 volunteers regarding technical image quality (4, excellent; 0, severely reduced), susceptibility to artifacts (3, absence; 0, massive), and visualization of anatomical structures in the oral cavity and surrounding skeletal structures (4, fine details visible; 0, no structures visible). Average image quality was good (3.29 ± 0.83) for all MRI protocols, with UTE providing the best image quality (3.52 ± 0.62) and no to minor artifacts (2.56 ± 0.6). Full diagnostic interpretability of the osseous structures is best in VIBE-Dixon and UTE MR-OPGs. DESS provided excellent visualization of the finest details of the nervous tissue (3.95 ± 0.22). Intra-reader and inter-reader agreement between the readers was good to excellent for all protocols (ICCs 0.812-0.957). MR-OPGs provide indication-specific accurate imaging of the oral cavity and could contribute to the early detection of pathologies, staging, and radiological follow-up of oral and maxillofacial diseases.
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Affiliation(s)
- Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland.
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Valérie Schmidt
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, CH-8032, Zurich, Switzerland
| | - Sebastian Winklhofer
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Daphne Schönegg
- Departement of Cranio-Maxillo-Facial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Stefan Sommer
- Siemens Healthineers International AG, Zurich, Switzerland
- Swiss Center for Musculoskeletal Imaging (SCMI), Balgrist Campus, Zurich, Switzerland
- Advanced Clinical Imaging Technology (ACIT), Siemens Healthcare AG, Lausanne, Switzerland
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Departement of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Jang H, Athertya J, Jerban S, Ma Y, Lombardi AF, Chung CB, Chang EY, Du J. Correction of B 0 and linear eddy currents: Impact on morphological and quantitative ultrashort echo time double echo steady state (UTE-DESS) imaging. NMR IN BIOMEDICINE 2023; 36:e4939. [PMID: 36965076 PMCID: PMC10518369 DOI: 10.1002/nbm.4939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 05/10/2023]
Abstract
The purpose of the current study was to investigate the effects of B0 and linear eddy currents on ultrashort echo time double echo steady state (UTE-DESS) imaging and to determine whether eddy current correction (ECC) effectively resolves imaging artifacts caused by eddy currents. 3D UTE-DESS sequences based on either projection radial or spiral cones trajectories were implemented on a 3-T clinical MR scanner. An off-isocentered thin-slice excitation approach was used to measure eddy currents. The measurements were repeated four times using two sets of tested gradient waveforms with opposite polarities and two different slice locations to measure B0 and linear eddy currents simultaneously. Computer simulation was performed to investigate the eddy current effect. Finally, a phantom experiment, an ex vivo experiment with human synovium and ankle samples, and an in vivo experiment with human knee joints, were performed to demonstrate the effects of eddy currents and ECC in UTE-DESS imaging. In a computer simulation, the two echoes (S+ and S-) in UTE-DESS imaging exhibited strong distortion at different orientations in the presence of B0 and linear eddy currents, resulting in both image degradation as well as misalignment of pixel location between the two echoes. The same phenomenon was observed in the phantom, ex vivo, and in vivo experiments, where the presence of eddy currents degraded S+, S-, echo subtraction images, and T2 maps. The implementation of ECC dramatically improved both the image quality and image registration between the S+ and S- echoes. It was concluded that ECC is crucial for reliable morphological and quantitative UTE-DESS imaging.
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Affiliation(s)
- Hyungseok Jang
- Department of Radiology, University of California, San Diego, USA
| | - Jiyo Athertya
- Department of Radiology, University of California, San Diego, USA
| | - Saeed Jerban
- Department of Radiology, University of California, San Diego, USA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, USA
| | | | - Christine B Chung
- Department of Radiology, University of California, San Diego, USA
- Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, USA
- Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, USA
- Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, USA
- Department of Bioengineering, University of California, San Diego, USA
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11
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Aljamani S, Youngson C, Jarad F, O'Neill F. Electrical stimulation to clinically identify position of the lingual nerve: results of 50 subjects with reliability and correlation with MRI. Oral Maxillofac Surg 2022; 26:253-260. [PMID: 34255234 PMCID: PMC9162997 DOI: 10.1007/s10006-021-00985-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 06/21/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE Recently we described mapping of the lingual nerve clinically in patients using electrical nerve stimulation. This paper reports results of a larger study with inter- and intra-observer reliability and comparison with positional measurements from magnetic resonance imaging (MRI). METHODS In 50 healthy participants, measurements were taken when subjects felt a tingling sensation in the tongue induced by a stimulation probe over the lingual nerve. Three positions were measured in relation to the third molar. Measurement reliability was tested for both inter-observer and intra-observer agreement and positional data of the lingual nerve measured clinically was also compared with nerve position as measured from MRI scans. RESULTS Out of 50 participants, 96 nerves (49 = left/47 = right) were included in the study. The lingual nerve was identified in 90% (87) of this sample. The mean of height of the nerve in points A, B and C were 9.64 mm, 10.77 mm and 12.34 respectively. Inter-and intra-observer agreement was considered to be good to excellent (ICC = 0.8-0.96). Agreement between nerve mapping measured values and MRI measured values was good (ICC < 0.6). CONCLUSION This technique may prove useful for the clinical determination of lingual nerve position prior to procedures in the third molar region.
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Affiliation(s)
- Sanaa Aljamani
- Restorative Unit, School of Dentistry, University of Liverpool, Liverpool, UK
- School of Dentistry, University of Jordan, Amman, Jordan
| | - Callum Youngson
- Restorative Unit, School of Dentistry, University of Liverpool, Liverpool, UK
| | - Fadi Jarad
- Restorative Unit, School of Dentistry, University of Liverpool, Liverpool, UK
| | - Francis O'Neill
- Oral Surgery Unit, School of Dentistry, University of Liverpool, Liverpool, UK.
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12
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Liu L, Liu H, Zhen Z, Zheng Y, Zhou X, Raithel E, Du J, Hu Y, Chen W, Hu X. Analysis of Knee Joint Injury Caused by Physical Training of Freshmen Students Based on 3T MRI and Automatic Cartilage Segmentation Technology: A Prospective Study. Front Endocrinol (Lausanne) 2022; 13:839112. [PMID: 35615719 PMCID: PMC9124811 DOI: 10.3389/fendo.2022.839112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background The differential effects of various exercises on knee joint injury have not been well documented. Improper physical training can cause irreversible damage to the knee joint. MRI is generally used to precisely analyze morphological and biochemical changes in the knee cartilage. We compared the effects of long-walking and regular daily physical training on acute and chronic knee joint injuries as well as cartilage structure in freshmen students. Methods A total of 23 young male college freshmen were recruited to participate in an 8-day 240 km long distance walk and a one-year daily training. 3D-DESSwe, 2D T2 mapping, DIXON, and T1WI of the right knee joint were performed using the MAGNETOM Spectra 3T MR scanner. The injury of meniscus, bone marrow edema, ligaments and joint effusion is graded. Cartilage volume, thickness and T2 values of 21 sub-regions of the knee cartilage were estimated using automatic cartilage segmentation prototype software. Friedman's test and Wilcoxon paired rank-sum test were used to compare quantitative indices of knee cartilage in three groups. Results The injury to the medial meniscus and anterior cruciate ligament of the knee joint, joint effusion, and bone marrow edema was significantly higher in the long-walking group compared to the baseline and daily groups. Furthermore, injury to the lateral meniscus was significantly worse in the long-walking group compared to the baseline group but was significantly better in the daily group compared to the baseline group. No significant changes to the posterior cruciate ligament were observed among the three groups. Knee cartilage volume was significantly increased, mainly in the stress surface of the femur, patella, and the lateral area of the tibial plateau. Regular daily training did not significantly change the thickness of the knee cartilage. Conversely, knee cartilage thickness decreased in the long-walking group, especially in the medial and lateral areas of the femur and tibial plateau. Moreover, no significant changes were observed in the knee cartilage volume of the long-walking group. Both long-walking and daily groups showed reduced T2 values of the knee joint compared to the baseline. Conclusion Among freshmen students and the training of this experimental intensity, our results show that regular daily training does not cause high-level injury to the knee joint, but improve the knee joint function adaptability by increasing cartilage volume. Moreover, knee injury caused by short-term long walking can be reversible.
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Affiliation(s)
- Lingling Liu
- Department of Radiology, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Henan Liu
- Department of Nuclear Medicine, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Zhiming Zhen
- Department of Radiology, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Yalan Zheng
- Department of Radiology, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Xiaoyue Zhou
- MR Collaboration, Siemens Healthineers Ltd., Shanghai, China
| | - Esther Raithel
- MR Application Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Jiang Du
- Health Service Training Base, Army Medical University, Chongqing, China
| | - Yan Hu
- Health Service Training Base, Army Medical University, Chongqing, China
| | - Wei Chen
- Department of Radiology, First Affiliated Hospital of Army Medical University, Chongqing, China
| | - Xiaofei Hu
- Department of Radiology, First Affiliated Hospital of Army Medical University, Chongqing, China
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13
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Al-Haj Husain A, Schönegg D, Valdec S, Stadlinger B, Gander T, Essig H, Piccirelli M, Winklhofer S. Visualization of Inferior Alveolar and Lingual Nerve Pathology by 3D Double-Echo Steady-State MRI: Two Case Reports with Literature Review. J Imaging 2022; 8:jimaging8030075. [PMID: 35324630 PMCID: PMC8954741 DOI: 10.3390/jimaging8030075] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 01/25/2023] Open
Abstract
Injury to the peripheral branches of the trigeminal nerve, particularly the lingual nerve (LN) and the inferior alveolar nerve (IAN), is a rare but serious complication that can occur during oral and maxillofacial surgery. Mandibular third molar surgery, one of the most common surgical procedures in dentistry, is most often associated with such a nerve injury. Proper preoperative radiologic assessment is hence key to avoiding neurosensory dysfunction. In addition to the well-established conventional X-ray-based imaging modalities, such as panoramic radiography and cone-beam computed tomography, radiation-free magnetic resonance imaging (MRI) with the recently introduced black-bone MRI sequences offers the possibility to simultaneously visualize osseous structures and neural tissue in the oral cavity with high spatial resolution and excellent soft-tissue contrast. Fortunately, most LN and IAN injuries recover spontaneously within six months. However, permanent damage may cause significant loss of quality of life for affected patients. Therefore, therapy should be initiated early in indicated cases, despite the inconsistency in the literature regarding the therapeutic time window. In this report, we present the visualization of two cases of nerve pathology using 3D double-echo steady-state MRI and evaluate evidence-based decision-making for iatrogenic nerve injury regarding a wait-and-see strategy, conservative drug treatment, or surgical re-intervention.
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Affiliation(s)
- Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (S.V.); (B.S.)
| | - Daphne Schönegg
- Clinic of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (D.S.); (T.G.); (H.E.)
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (S.V.); (B.S.)
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (S.V.); (B.S.)
| | - Thomas Gander
- Clinic of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (D.S.); (T.G.); (H.E.)
| | - Harald Essig
- Clinic of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (D.S.); (T.G.); (H.E.)
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland;
| | - Sebastian Winklhofer
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland;
- Correspondence: ; Tel.: +41-44-253-83-96
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Kwon D, Lee C, Chae Y, Kwon IJ, Kim SM, Lee JH. Clinical validation of the 3-dimensional double-echo steady-state with water excitation sequence of MR neurography for preoperative facial and lingual nerve identification. Imaging Sci Dent 2022; 52:259-266. [PMID: 36238701 PMCID: PMC9530289 DOI: 10.5624/isd.20220035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/11/2022] [Accepted: 04/13/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Dohyun Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
- Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Seoul, Korea
| | - Chena Lee
- Department of Oral and Maxillofacial Radiology, College of Dentistry, Yonsei University, Seoul, Korea
| | - YeonSu Chae
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Ik Jae Kwon
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Soung Min Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
| | - Jong-Ho Lee
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul, Korea
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New and Advanced Magnetic Resonance Imaging Diagnostic Imaging Techniques in the Evaluation of Cranial Nerves and the Skull Base. Neuroimaging Clin N Am 2021; 31:665-684. [PMID: 34689938 DOI: 10.1016/j.nic.2021.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The skull base and cranial nerves are technically challenging to evaluate using magnetic resonance (MR) imaging, owing to a combination of anatomic complexity and artifacts. However, improvements in hardware, software and sequence development seek to address these challenges. This section will discuss cranial nerve imaging, with particular attention to the techniques, applications and limitations of MR neurography, diffusion tensor imaging and tractography. Advanced MR imaging techniques for skull base pathology will also be discussed, including diffusion-weighted imaging, perfusion and permeability imaging, with a particular focus on practical applications.
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Comparison of Preoperative Cone-Beam Computed Tomography and 3D-Double Echo Steady-State MRI in Third Molar Surgery. J Clin Med 2021; 10:jcm10204768. [PMID: 34682896 PMCID: PMC8540951 DOI: 10.3390/jcm10204768] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/05/2021] [Accepted: 10/15/2021] [Indexed: 12/26/2022] Open
Abstract
We investigated the reliability of assessing a positional relationship between the inferior alveolar nerve (IAN) and mandibular third molar (MTM) based on CBCT, 3D-DESS MRI, and CBCT/MRI image fusion. Furthermore, we evaluated qualitative parameters such as inflammatory processes and imaging fusion patterns. Therefore, two raters prospectively assessed in 19 patients with high-risk MTM surgery cases several parameters for technical image quality and diagnostic ability using modified Likert rating scales. Inter- and intra-reader agreement was evaluated by performing weighted kappa analysis. The inter- and intra-reader agreement for the positional relationship was moderate (κ = 0.566, κ = 0.577). Regarding the detectability of inflammatory processes, the agreement was substantial (κ = 0.66, κ = 0.668), with MRI providing a superior diagnostic benefit regarding early inflammation detection. Independent of the readers’ experience, the agreement of judgment in 3D-DESS MRI was adequate. Black bone MRI sequences such as 3D-DESS MRI providing highly confidential preoperative assessment in MTM surgery have no significant limitations in diagnostic information. With improved cost and time efficiency, dental MRI has the potential to establish itself as a valid alternative in high-risk cases compared to CBCT in future clinical routine.
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Al-Haj Husain A, Valdec S, Stadlinger B, Rücker M, Piccirelli M, Winklhofer S. Preoperative visualization of the lingual nerve by 3D double-echo steady-state MRI in surgical third molar extraction treatment. Clin Oral Investig 2021; 26:2043-2053. [PMID: 34586501 PMCID: PMC8816737 DOI: 10.1007/s00784-021-04185-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 09/18/2021] [Indexed: 11/28/2022]
Abstract
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. Supplementary Information The online version contains supplementary material available at 10.1007/s00784-021-04185-z.
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Affiliation(s)
- Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Martin Rücker
- Clinic of Cranio-Maxillofacial and Oral Surgery, University Hospital of Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Marco Piccirelli
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
| | - Sebastian Winklhofer
- Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
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Al-Haj Husain A, Stadlinger B, Winklhofer S, Müller M, Piccirelli M, Valdec S. Mandibular Third Molar Surgery: Intraosseous Localization of the Inferior Alveolar Nerve Using 3D Double-Echo Steady-State MRI (3D-DESS). Diagnostics (Basel) 2021; 11:diagnostics11071245. [PMID: 34359328 PMCID: PMC8303593 DOI: 10.3390/diagnostics11071245] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/02/2021] [Accepted: 07/07/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to evaluate the inferior alveolar nerve's (IAN) intraosseous position within the inferior alveolar canal (IAC) using a 3D double-echo steady-state MRI sequence (3D-DESS). The IAN position was prospectively evaluated in 19 patients undergoing mandibular third molar (MTM) surgery. In the coronal reference layer, the IAC was divided into six segments. These segments were checked for the presence of hyperintense tubular MRI signals representing the IAN's nervous tissue and assessed as visible/non-visible. Furthermore, the IAN in MRI and the IAC in MRI and CBCT were segmented at the third and second molar, determining the maximum diameter in all planes and a conversion factor between the imaging modalities. Regardless of the positional relationship at the third and second molar, the IAN showed the highest localization probability in the central segments (segment 2: 97.4% vs. 94.4%, segment 5: 100% vs. 91.6%). The conversion factors from IAC in CBCT and MRI to IAN in MRI, respectively, were the following: axial (2.04 ± 1.95, 2.37 ± 2.41), sagittal (1.86 ± 0.96, 1.76 ± 0.74), and coronal (1.26 ± 0.39, 1.37 ± 0.25). This radiation-free imaging modality, demonstrating good feasibility of accurate visualization of nervous tissue within the nerve canal's osseous boundaries, may benefit preoperative assessment before complex surgical procedures are performed near the IAC.
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Affiliation(s)
- Adib Al-Haj Husain
- Center of Dental Medicine, Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (B.S.)
| | - Bernd Stadlinger
- Center of Dental Medicine, Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (B.S.)
| | - Sebastian Winklhofer
- Clinical Neuroscience Center, Department of Neuroradiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (S.W.); (M.P.)
| | - Marcel Müller
- Statistical Services, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland;
| | - Marco Piccirelli
- Clinical Neuroscience Center, Department of Neuroradiology, University Hospital of Zurich, University of Zurich, 8091 Zurich, Switzerland; (S.W.); (M.P.)
| | - Silvio Valdec
- Center of Dental Medicine, Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, 8032 Zurich, Switzerland; (A.A.-H.H.); (B.S.)
- Department of Stomatology, Division of Periodontology, Dental School, University of São Paulo, Butantã 2227, SP, Brazil
- Correspondence: ; Tel.: +41-44-634-32-90
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Li S, Zhang S, Yu Z, Lin Y. MRI of the intraorbital ocular motor nerves on three-dimensional double-echo steady state with water excitation sequence at 3.0 T. Jpn J Radiol 2021; 39:749-754. [PMID: 33811598 DOI: 10.1007/s11604-021-01111-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 03/24/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To explore the capability of three-dimensional double-echo steady state with water excitation sequence (3D-DESS-WE) to determine the intraorbital ocular motor nerves (IOMN). MATERIALS AND METHODS A 3.0 T scanner was applied to investigate 30 healthy volunteers based on the 3D-DESS-WE sequence. Dunnett t test was conducted to evaluate the signal intensity (SI) of the left oculomotor nerve (CNIII), frontal white matter, cerebrospinal fluid (CSF), and lateral rectus (LR). The oculomotor nerve's detectability, trochlear nerve (CNIV), and abducens nerve (CNVI) were evaluated independently by two observers. The average assessment scores were determined, and interobserver variability for these nerves' detectability was determined using a weighted kappa analysis. RESULTS The SI of CNIII is similar to that of the frontal white matter (t = 2.26, P > 0.05), lower than the CSF, and higher than the LR (t = 3.81, - 3.45, P < 0.05). The average scores of the superior division of CNIII and the branch to medial rectus (MR), inferior rectus (IR), inferior oblique (IO), CNIV, and CNVI were 3.01, 3.07, 3.78, 2.98, 2.88, and 3.97, respectively. The interobserver variability was excellent (κ = 0.83-1.00). CONCLUSION The 3D-DESS-WE sequence shows an ability to detect the IOMN course in healthy volunteers effectively.
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Affiliation(s)
- Shengkai Li
- Department of MRI, Meizhou People's Hospital, Huangtang Road, Meijiang, Meizhou, 514031, Guangdong Province, People's Republic of China.
| | - Siyu Zhang
- Department of MRI, Meizhou People's Hospital, Huangtang Road, Meijiang, Meizhou, 514031, Guangdong Province, People's Republic of China
| | - Zhao Yu
- Department of MRI, Meizhou People's Hospital, Huangtang Road, Meijiang, Meizhou, 514031, Guangdong Province, People's Republic of China
| | - You Lin
- Department of MRI, Meizhou People's Hospital, Huangtang Road, Meijiang, Meizhou, 514031, Guangdong Province, People's Republic of China
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Jang H, Ma Y, Carl M, Jerban S, Chang EY, Du J. Ultrashort echo time Cones double echo steady state (UTE-Cones-DESS) for rapid morphological imaging of short T 2 tissues. Magn Reson Med 2021; 86:881-892. [PMID: 33755258 DOI: 10.1002/mrm.28769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE In this study, we aimed to develop a new technique, ultrashort echo time Cones double echo steady state (UTE-Cones-DESS), for highly efficient morphological imaging of musculoskeletal tissues with short T2 s. We also proposed a novel, single-point Dixon (spDixon)-based approach for fat suppression. METHODS The UTE-Cones-DESS sequence was implemented on a 3T MR system. It uses a short radiofrequency (RF) pulse followed by a pair of balanced spiral-out and spiral-in readout gradients separated by an unbalanced spoiling gradient in-between. The readout gradients are applied immediately before or after the RF pulses to achieve a UTE image (S+ ) and a spin/stimulated echo image (S- ). Weighted echo subtraction between S+ and S- was performed to achieve high contrast specific to short T2 tissues, and spDixon was applied to suppress fat by using the intrinsic complex signal of S+ and S- . Six healthy volunteers and five patients with osteoarthritis were recruited for whole-knee imaging. Additionally, two healthy volunteers were recruited for lower leg imaging. RESULTS The UTE-Cones-DESS sequence allows fast volumetric imaging of musculoskeletal tissues with excellent image contrast for the osteochondral junction, tendons, menisci, and ligaments in the knee joint as well as cortical bone and aponeurosis in the lower leg within 5 min. spDixon yields efficient fat suppression in both S+ and S- images without requiring any additional acquisitions or preparation pulses. CONCLUSION The rapid UTE-Cones-DESS sequence can be used for high contrast morphological imaging of short T2 tissues, providing a new tool to assess their association with musculoskeletal disorders.
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Affiliation(s)
- Hyungseok Jang
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | - Yajun Ma
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | | | - Saeed Jerban
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
| | - Eric Y Chang
- Department of Radiology, University of California, San Diego, San Diego, CA, USA.,Radiology Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Jiang Du
- Department of Radiology, University of California, San Diego, San Diego, CA, USA
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Kim Y, Jeong HS, Kim HJ, Seong M, Kim Y, Kim ST. Three-dimensional double-echo steady-state with water excitation magnetic resonance imaging to localize the intraparotid facial nerve in patients with deep-seated parotid tumors. Neuroradiology 2021; 63:731-739. [PMID: 33595681 DOI: 10.1007/s00234-021-02673-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/07/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the utility of three-dimensional double-echo steady-state with water excitation (3D-DESS-WE) imaging for localizing deep-seated parotid tumors in relation to the facial nerve. METHODS A prospective study comparing the surgical outcomes of parotidectomy with or without 3D-DESS-WE sequence is currently enrolling the patients. Magnetic resonance imaging data from the first 25 patients with 3D-DESS-WE sequence were reviewed. Visibility of the intraparotid facial nerve was independently assessed by two neuroradiologists. The diagnostic performance of the 3D-DESS-WE sequence for prediction of deep lobe involvement was compared with that of two conventional methods based on the retromandibular vein line (RMVL) and facial nerve line (FNL). The relationship between the tumor and the main trunk of the facial nerve was also evaluated on the 3D-DESS-WE sequence. RESULTS On 3D-DESS-WE images, the main trunk, temporofacial division, and cervicofacial division of the intraparotid facial nerve were visualized in 100% (25/25), 48% (12/25), and 36% (9/25) of patients, respectively. The diagnostic accuracy of the 3D-DESS-WE sequence for prediction of deep lobe involvement was 92% (23/25), which was significantly superior to that of the RMVL (68% [17/25]; p = 0.008) and FNL (64% [16/25]; p = 0.004) methods. The relationship between the tumor and the main trunk of the facial nerve was correctly predicted in 92% (23/25) of 3D-DESS-WE images. CONCLUSION By direct visualization of the facial nerve, the 3D-DESS-WE sequence improved the preoperative localization of the intraparotid facial nerve in deep-seated parotid tumors. This information may help better surgical planning for deep-seated parotid tumors.
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Affiliation(s)
- Yikyung Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Han-Sin Jeong
- Department of Otorhinolaryngology and Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyung-Jin Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
| | - Minjung Seong
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Yoonha Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Sung Tae Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
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High-resolution in vivo MR imaging of intraspinal cervical nerve rootlets at 3 and 7 Tesla. Eur Radiol 2021; 31:4625-4633. [PMID: 33409779 DOI: 10.1007/s00330-020-07557-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/09/2020] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVES No routine imaging technology allows reliable visualization of nerve rootlets inside the spinal canal with positive contrast. The stronger MR signal at 7 T, with optimized protocols, may offer a solution. The purpose was to evaluate the potential of 3D Dual-Echo Steady-State (DESS) MR imaging of the cervical spine at 3 and 7 T in assessing the micro-anatomy of the nerve rootlets. MATERIALS/METHODS This prospective study was approved by the local ethics committee. Twenty-one patients, clinically referred to cervical-spine MRI, underwent additional MR exams at 3 T and 7 T, each of which consisted of a single 3D-DESS series with equal acquisition times. Artifacts, visualization quality, and number of identified rootlets (C2 to C8) were rated by two musculoskeletal radiologists. Results were compared by Wilcoxon tests. Interobserver reliability was assessed using weighted κ statistics and intraclass correlation coefficient (ICC). RESULTS Intraspinal rootlets could successfully be visualized at both field strengths. Rating differences for artifacts and quality of rootlet depiction were not significant for the two field strengths. The mean number of identified rootlets was larger for 7-T than for 3-T MR for every assessed nerve; however, this difference was not statistically significant using the Bonferroni correction (p values ranging from 0.002 to 0.53). Interobserver agreement was substantial to almost perfect (weighted κ values of 0.69 and 0.82). The ICC for the number of identified rootlets was 0.80. CONCLUSION Non-invasive 3D-DESS MR-imaging at 3 and 7 T has the potential to provide precise assessments of the micro-anatomy of intraspinal cervical nerve roots. KEY POINTS • Cervical rootlets can be successfully visualized with positive contrast using 3D-DESS MR-imaging. • 3D-DESS MR-imaging at 3 and 7 T provides precise assessments of the micro-anatomy of cervical nerves. • The mean number of identified cervical rootlets using 3D-DESS was larger for 7 T than for 3 T MR; however, this difference was not statistically significant.
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Lee MK, Choi Y, Jang J, Shin NY, Jung SL, Ahn KJ, Kim BS. Identification of the intraparotid facial nerve on MRI: a systematic review and meta-analysis. Eur Radiol 2020; 31:629-639. [PMID: 32857205 DOI: 10.1007/s00330-020-07222-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/03/2020] [Accepted: 08/21/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Accurate preoperative localization of the intraparotid facial nerve (IFN) on MRI could reduce intraoperative injury. This study aimed to assess the detection rate of the IFN and its branches on MRI. METHODS PubMed-MEDLINE and Embase databases were searched for articles published up to October 2019. The inclusion criteria were (a) adults, (b) MRI-based identification of IFN by radiologists, (c) original articles, and (d) detailed results to assess the proportion of visible IFN. Two radiologists reviewed the original articles. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to determine the quality of the selected studies. The DerSimonian-Laird random effects model was utilized to calculate the pooled estimates. Between-studies heterogeneity was evaluated using the chi-squared statistic test and Higgins' inconsistency index (I2). A subgroup meta-regression was performed to explore the factors causing study heterogeneity. RESULTS Nine original articles with 209 subjects were included. MRI reported a high pooled detection rate of 99.8% (95% CI, 98.4-100%) for the main trunk of the IFN. The pooled rates for the temporofacial and cervicofacial branches were 90.4% (95% CI, 84.1-96.7%) and 96.3% (95% CI, 96.1-99.5%), respectively. Heterogeneity was detected only in the temporofacial branch (I2 = 83%) as a result of both slice thickness and the use of steady-state sequences with diffusion-weighted imaging (DWI) implementation. CONCLUSIONS MRI showed an overall high detection rate of the IFN and its branches. Furthermore, an increased identification was observed in studies that used a slice thickness of < 1 mm and steady-state sequences with DWI implementation. KEY POINTS • MRI showed an overall high detection rate of the intraparotid facial nerve and its branches. • Higher detection rate was observed in studies that used a slice thickness of < 1 mm and steady-state sequences with diffusion-weighted imaging.
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Affiliation(s)
- Min-Kyung Lee
- Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 63-ro 10, Yeongdeungpo-gu, Seoul, 07345, South Korea
| | - Yangsean Choi
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea.
| | - Jinhee Jang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - Na-Young Shin
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - So-Lyung Jung
- Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 63-ro 10, Yeongdeungpo-gu, Seoul, 07345, South Korea
| | - Kook-Jin Ahn
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
| | - Bum-Soo Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, South Korea
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Mantsopoulos K, Tschaikowsky N, Goncalves M, Mueller SK, Iro H. Evaluation of preoperative Ultrasonography in the Differentiation between Superficial and Deep Parotid Gland Tumors. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:2099-2103. [PMID: 32487325 DOI: 10.1016/j.ultrasmedbio.2020.04.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 04/21/2020] [Accepted: 04/24/2020] [Indexed: 06/11/2023]
Abstract
Imaging of the intraparotid course of the facial nerve remains a challenge and is not an established routine procedure. The aim of this study was to evaluate ultrasound in localizing a parotid tumor in relation to the facial nerve. The ultrasound findings and operative reports of all patients treated for parotid gland tumors were studied retrospectively. Eight hundred sixty-eight parotid lesions formed our study sample. The unit of measurement was the minimal distance between the parotideomasseteric fascia and the superficial capsule of the tumor, measured in millimeters by means of ultrasound. The mean value for this parameter was 1.3 mm for superficial and 4.6 mm for deep lobe tumors (p < 0.001). When the cutoff value was set at 2.6 mm, the sensitivity and specificity of ultrasound were 89.6 and 88.4%, respectively. Our study revealed that ultrasound can help in the pre-operative differentiation between tumors of the superficial and deep lobes of the parotid gland.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Nastasja Tschaikowsky
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Miguel Goncalves
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Sarina Katrin Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Kikuchi T, Fujii H, Fujita A, Sugimoto H. Visualization of the greater and lesser occipital nerves on three-dimensional double-echo steady-state with water excitation sequence. Jpn J Radiol 2020; 38:753-760. [DOI: 10.1007/s11604-020-00969-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 03/30/2020] [Indexed: 11/30/2022]
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26
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Jung YG, Kim YK, Kim HJ, Jeong HS. Three-dimensional reconstruction of the facial nerve course in parotid gland tumor using double echo steady state with water-excitation magnetic resonance images. PRECISION AND FUTURE MEDICINE 2020. [DOI: 10.23838/pfm.2020.00086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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27
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Wu W, Wu F, Liu D, Zheng C, Kong X, Shu S, Li D, Kong X, Wang L. Visualization of the morphology and pathology of the peripheral branches of the cranial nerves using three-dimensional high-resolution high-contrast magnetic resonance neurography. Eur J Radiol 2020; 132:109137. [PMID: 33022550 DOI: 10.1016/j.ejrad.2020.109137] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 03/25/2020] [Accepted: 06/13/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE To assess the feasibility and advantages of high-resolution high-contrast magnetic resonance neurography (HRHC-MRN) for visualizing the morphology and pathology of the peripheral branches of cranial nerves. MATERIALS cMRN (3D SPACE STIR sequence) and HRHC-MRN (contrast enhanced 3D SPACE STIR sequence) were performed at 3 T MR unit on 16 volunteers and 12 patients with head and neck tumors. Quantitative measurements such as SNR, CNR and CR were calculated. Three readers evaluated the continuity of the 10 major peripheral branches of cranial nerves using a 5-score scale (scores 0-4). Interobserver variability was tested. Quantitative measurements and scores were compared between cMRN and HRHC-MRN. The imaging features of the nerve pathology were analyzed. RESULTS The CRs of nerve to bone marrow, nerve to muscle, and nerve to gland were significantly higher with HRHC-MRN than with cMRN (P = 0.014, P = 0.02, P <0.001, respectively). The scores of all nerve trunks were significantly higher with HRHC-MRN than with cMRN (all, P < 0.001). For all nerves on HRHC-MRN, the interobserver consistency was excellent across the three readers (all κ > 0.8). The scores of the inferior alveolar nerve, hypoglossal nerve, lingual nerve, facial nerve, infraorbital nerve, masseteric nerve, glossopharyngeal/vagus nerve, supraorbital nerve, auriculotemporal nerve and buccal nerve were 3.95, 3.77, 3.63, 3.25, 3.15, 3.04, 3.04, 2.87, 2.79, 1.88, respectively. CONCLUSION HRHC-MRN provides improved visualization of the peripheral branches of cranial nerves and is a promising nerve-selective imaging method for evaluating cranial nerve morphology and pathology.
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Affiliation(s)
- Wenjun Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Feihong Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Dingxi Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
| | - Chuansheng Zheng
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Xiangquan Kong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Shenglei Shu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Dan Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Xiangchuang Kong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Lixia Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
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El Kininy W, Roddy D, Davy S, Roman E, O'Keane V, O'Hanlon E, Barry D, Stassen LFA. Magnetic resonance diffusion weighted imaging using constrained spherical deconvolution-based tractography of the extracranial course of the facial nerve. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:e44-e56. [PMID: 32033932 DOI: 10.1016/j.oooo.2019.12.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 12/07/2019] [Accepted: 12/20/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To evaluate the accuracy of magnetic resonance diffusion weighted imaging (DWI) featuring constrained spherical deconvolution-based tractography in tracking the extracranial course of the facial nerve to provide a reliable facial nerve map to facilitate well-tolerated and effective tumor resection. STUDY DESIGN Magnetic resonance DWI was conducted on 2 parotid-healthy cadaveric patients with various protocols to identify the best representation of the extracranial facial nerve tract. This was subsequently correlated to dissection of the facial nerves to ascertain anatomic validation. These protocols were applied to 2 live, parotid-healthy patients to assess feasibility of in vivo facial nerve tract identification. RESULTS Correlations between imaged tracts and the anatomic course of the extracranial facial nerve were identified to an accuracy of 1 mm. The main trunk and bifurcation tracts were identified on imaging. Fractional anisometry values in cadaveric and live patients were within the range expected for the facial nerve within the parotid gland. CONCLUSIONS Our results indicated the potential for accurate 3-dimensional visualization of the extracranial course of the facial nerve, which could have diagnostic implications in differentiating benign from malignant tumors and, crucially, neural involvement. Preoperative planning applications of DWI could help in planning surgical approaches and providing focused counseling.
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Affiliation(s)
- Walid El Kininy
- Trinity College Dublin - M.D. post graduate doctorate and Specialist Registrar, Oral & Maxillofacial Surgery, Kent Surrey Sussex Deanery, UK.
| | - Darren Roddy
- Neuroscience Institute, Trinity College Dublin, Dublin, Ireland
| | - Shane Davy
- Department of Anatomy, Trinity College Dublin
| | | | | | - Erik O'Hanlon
- Senior postdoctoral research fellow, Neuroscience, Trinity College Dublin
| | - Denis Barry
- Assistant professor and M.D. supervisor, Department of Anatomy, Trinity College Dublin
| | - Leo F A Stassen
- Professor and chair of Oral/Maxillofacial Surgery and M.D. supervisor, Trinity College Dublin
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Kim HJ, Seong M, Kim Y. Normal Anatomy of Cranial Nerves III–XII on Magnetic Resonance Imaging. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2020; 81:501-529. [PMID: 36238638 PMCID: PMC9431917 DOI: 10.3348/jksr.2020.81.3.501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/02/2020] [Indexed: 11/15/2022]
Abstract
복잡한 해부학적 구조와 기능 때문에 뇌신경 질환의 신경영상검사는 항상 어려운 과제이다. 최근 자기공명영상(이하 MRI) 기법의 발달로 많은 경우에서 뇌신경 질환의 원인이 규명되고 있으며, 신경영상의학 의사들은 다학제 팀의 핵심적 팀원으로서 다양한 뇌신경 질환의 원활한 진단을 위하여 MRI에서 관찰되는 뇌신경의 세밀한 해부학적 구조를 잘 알아야 한다. 이 종설에서는 말초성 뇌신경 III–XII에 대해 뇌간으로부터 두개 밖까지 해부학적으로 비슷한 구조를 가지는 구역별로 분류하여 각 구역에서 보이는 뇌신경의 정상 해부학 및 MRI 소견을 설명하고자 한다. 또한 각 구역에서 가장 적합한 MRI 기법에 관하여도 기술하고자 한다.
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Affiliation(s)
- Hyung-Jin Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Minjung Seong
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yikyung Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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30
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Touska P, Connor SEJ. Recent advances in MRI of the head and neck, skull base and cranial nerves: new and evolving sequences, analyses and clinical applications. Br J Radiol 2019; 92:20190513. [PMID: 31529977 PMCID: PMC6913354 DOI: 10.1259/bjr.20190513] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Revised: 09/09/2019] [Accepted: 09/12/2019] [Indexed: 12/14/2022] Open
Abstract
MRI is an invaluable diagnostic tool in the investigation and management of patients with pathology of the head and neck. However, numerous technical challenges exist, owing to a combination of fine anatomical detail, complex geometry (that is subject to frequent motion) and susceptibility effects from both endogenous structures and exogenous implants. Over recent years, there have been rapid developments in several aspects of head and neck imaging including higher resolution, isotropic 3D sequences, diffusion-weighted and diffusion-tensor imaging as well as permeability and perfusion imaging. These have led to improvements in anatomic, dynamic and functional imaging. Further developments using contrast-enhanced 3D FLAIR for the delineation of endolymphatic structures and black bone imaging for osseous structures are opening new diagnostic avenues. Furthermore, technical advances in compressed sensing and metal artefact reduction have the capacity to improve imaging speed and quality, respectively. This review explores novel and evolving MRI sequences that can be employed to evaluate diseases of the head and neck, including the skull base.
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Affiliation(s)
- Philip Touska
- Department of Radiology, Guy’s and St. Thomas’ NHS Foundation Trust, Guy’s Hospital, Great Maze Pond, London, SE1 9RT, United Kingdom
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31
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Guenette JP, Ben-Shlomo N, Jayender J, Seethamraju RT, Kimbrell V, Tran NA, Huang RY, Kim CJ, Kass JI, Corrales CE, Lee TC. MR Imaging of the Extracranial Facial Nerve with the CISS Sequence. AJNR Am J Neuroradiol 2019; 40:1954-1959. [PMID: 31624121 DOI: 10.3174/ajnr.a6261] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/27/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging is not routinely used to image the extracranial facial nerve. The purpose of this study was to determine the extent to which this nerve can be visualized with a CISS sequence and to determine the feasibility of using that sequence for locating the nerve relative to tumor. MATERIALS AND METHODS Thirty-two facial nerves in 16 healthy subjects and 4 facial nerves in 4 subjects with parotid gland tumors were imaged with an axial CISS sequence protocol that included 0.8-mm isotropic voxels on a 3T MR imaging system with a 64-channel head/neck coil. Four observers independently segmented the 32 healthy subject nerves. Segmentations were compared by calculating average Hausdorff distance values and Dice similarity coefficients. RESULTS The primary bifurcation of the extracranial facial nerve into the superior temporofacial and inferior cervicofacial trunks was visible on all 128 segmentations. The mean of the average Hausdorff distances was 1.2 mm (range, 0.3-4.6 mm). Dice coefficients ranged from 0.40 to 0.82. The relative position of the facial nerve to the tumor could be inferred in all 4 tumor cases. CONCLUSIONS The facial nerve can be seen on CISS images from the stylomastoid foramen to the temporofacial and cervicofacial trunks, proximal to the parotid plexus. Use of a CISS protocol is feasible in the clinical setting to determine the location of the facial nerve relative to tumor.
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Affiliation(s)
- J P Guenette
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - N Ben-Shlomo
- Otolaryngology-Head and Neck Surgery (N.B.-S., J.I.K., C.E.C), Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - J Jayender
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - R T Seethamraju
- Siemens Medical Solutions USA (R.T.S.), Boston, Massachusetts
| | - V Kimbrell
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - N-A Tran
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - R Y Huang
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - C J Kim
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
| | - J I Kass
- Otolaryngology-Head and Neck Surgery (N.B.-S., J.I.K., C.E.C), Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - C E Corrales
- Otolaryngology-Head and Neck Surgery (N.B.-S., J.I.K., C.E.C), Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - T C Lee
- From the Divisions of Neuroradiology (J.P.G., J.J., V.K., N.-A.T., R.Y.H., C.J.K., T.C.L.)
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Fujii H, Fujita A, Kanazawa H, Sung E, Sakai O, Sugimoto H. Localization of Parotid Gland Tumors in Relation to the Intraparotid Facial Nerve on 3D Double-Echo Steady-State with Water Excitation Sequence. AJNR Am J Neuroradiol 2019; 40:1037-1042. [PMID: 31122915 DOI: 10.3174/ajnr.a6078] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 04/21/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Reliable preoperative facial nerve mapping may help avoid or minimize facial nerve injury during parotid tumor resection. The purpose of this study was to investigate the diagnostic performance of the 3D double-echo steady-state with water excitation sequence in localizing parotid gland tumors through direct visualization of the intraparotid facial nerve in comparison with indirect methods of estimating the facial nerve location. MATERIALS AND METHODS We retrospectively reviewed 91 parotid gland tumors in 90 patients who underwent surgical resection and preoperative MR imaging, including the 3D double-echo steady-state with water excitation sequence. The tumor locations were categorized as deep or superficial on the basis of direct and 3 indirect methods: the facial nerve line, retromandibular vein, and Utrecht line. Surgical localization was considered the criterion standard. The diagnostic performance for localizing deep lobe lesions using direct and indirect methods was calculated and compared using the McNemar test. RESULTS Surgical localization confirmed 75 superficial lesions and 16 deep lesions. The interobserver variability of the 3D double-echo steady-state with water excitation sequence was excellent (κ = 0.870). The diagnostic accuracy, sensitivity, specificity, positive predictive value, and negative predictive value for localizing deep lobe lesions using the 3D double-echo steady-state with water excitation method were 97.8%, 87.5%, 100%, 100%, and 97.4%, respectively. These findings were significantly higher than the facial nerve line in sensitivity, the retromandibular vein in sensitivity, and the Utrecht line in accuracy and specificity (P < .05). Overall, the direct method was the most accurate, sensitive, and specific in localizing parotid gland tumors. CONCLUSIONS We can achieve higher diagnostic performance in localizing parotid gland tumors by directly visualizing the intraparotid facial nerve using the 3D double-echo steady-state with water excitation sequence compared with indirect methods.
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Affiliation(s)
- H Fujii
- From the Department of Radiology (H.F., A.F., H.K., H.S.), Jichi Medical University, School of Medicine, Tochigi, Japan
| | - A Fujita
- From the Department of Radiology (H.F., A.F., H.K., H.S.), Jichi Medical University, School of Medicine, Tochigi, Japan
| | - H Kanazawa
- From the Department of Radiology (H.F., A.F., H.K., H.S.), Jichi Medical University, School of Medicine, Tochigi, Japan
| | - E Sung
- Departments of Radiology (E.S., O.S.)
| | - O Sakai
- Departments of Radiology (E.S., O.S.).,Otolaryngology-Head and Neck Surgery (O.S.).,Radiation Oncology (O.S.), Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - H Sugimoto
- From the Department of Radiology (H.F., A.F., H.K., H.S.), Jichi Medical University, School of Medicine, Tochigi, Japan
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Park W, Park J, Park SI, Kim H, Bae H, Cho J, Won H, Park M, Jeong HS. Clinical outcomes and management of facial nerve in patients with parotid gland cancer and pretreatment facial weakness. Oral Oncol 2019; 89:144-149. [DOI: 10.1016/j.oraloncology.2019.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 12/28/2018] [Accepted: 01/06/2019] [Indexed: 10/27/2022]
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Chhabra A, Bajaj G, Wadhwa V, Quadri RS, White J, Myers LL, Amirlak B, Zuniga JR. MR Neurographic Evaluation of Facial and Neck Pain: Normal and Abnormal Craniospinal Nerves below the Skull Base. Radiographics 2018; 38:1498-1513. [DOI: 10.1148/rg.2018170194] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Imaging of Sjögren Syndrome and Immunoglobulin G4-Related Disease of the Salivary Glands. Neuroimaging Clin N Am 2018; 28:183-197. [DOI: 10.1016/j.nic.2018.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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High-Resolution Isotropic Three-Dimensional MR Imaging of the Extraforaminal Segments of the Cranial Nerves. Magn Reson Imaging Clin N Am 2018; 26:101-119. [DOI: 10.1016/j.mric.2017.08.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Attyé A, Karkas A, Troprès I, Roustit M, Kastler A, Bettega G, Lamalle L, Renard F, Righini C, Krainik A. Parotid gland tumours: MR tractography to assess contact with the facial nerve. Eur Radiol 2015; 26:2233-41. [DOI: 10.1007/s00330-015-4049-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 09/11/2015] [Accepted: 09/25/2015] [Indexed: 11/30/2022]
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Fujii H, Fujita A, Yang A, Kanazawa H, Buch K, Sakai O, Sugimoto H. Visualization of the Peripheral Branches of the Mandibular Division of the Trigeminal Nerve on 3D Double-Echo Steady-State with Water Excitation Sequence. AJNR Am J Neuroradiol 2015; 36:1333-7. [PMID: 25836724 DOI: 10.3174/ajnr.a4288] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 12/17/2014] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Although visualization of the extracranial branches of the cranial nerves has improved with advances in MR imaging, only limited studies have assessed the detection of extracranial branches of the mandibular nerve (V3). We investigated the detectability of the branches of V3 on a 3D double-echo steady-state with water excitation sequence. MATERIALS AND METHODS We retrospectively evaluated the detectability of the 6 branches of the V3, the masseteric, buccal, auriculotemporal, lingual, inferior alveolar, and mylohyoid nerves, by using a 5-point scale (4, excellent; 3, good; 2, fair; 1, poor; and 0, none) in 86 consecutive patients who underwent MR imaging with the 3D double-echo steady-state with water excitation sequence. Weighted κ analysis was used to calculate interobserver variability among the 3 readers. RESULTS The detection of the lingual and inferior alveolar nerves was the most successful, with excellent average scores of 3.80 and 3.99, respectively. The detection of the masseteric, the buccal, and the auriculotemporal nerves was good, with average scores of 3.31, 2.67, and 3.11, respectively. The mylohyoid nerve was difficult to detect with poor average scores of 0.62. All nerves had excellent interobserver variability across the 3 readers (average weighted κ value, 0.95-1.00). CONCLUSIONS The 3D double-echo steady-state with water excitation sequence demonstrated excellent visualization of the extracranial branches of V3 in most patients. The 3D double-echo steady-state with water excitation sequence has the potential for diagnosing V3 pathologies and preoperatively identifying peripheral cranial nerves to prevent surgical complications.
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Affiliation(s)
- H Fujii
- From the Department of Radiology (H.F., A.F., H.K., H.S.), Jichi Medical University School of Medicine, Tochigi, Japan
| | - A Fujita
- From the Department of Radiology (H.F., A.F., H.K., H.S.), Jichi Medical University School of Medicine, Tochigi, Japan Departments of Radiology (A.F., K.B., O.S.)
| | - A Yang
- Boston University School of Medicine (A.Y.), Boston, Massachusetts
| | - H Kanazawa
- From the Department of Radiology (H.F., A.F., H.K., H.S.), Jichi Medical University School of Medicine, Tochigi, Japan
| | - K Buch
- Departments of Radiology (A.F., K.B., O.S.)
| | - O Sakai
- Departments of Radiology (A.F., K.B., O.S.) Otolaryngology-Head and Neck Surgery (O.S.) Radiation Oncology (O.S.), Boston Medical Center
| | - H Sugimoto
- From the Department of Radiology (H.F., A.F., H.K., H.S.), Jichi Medical University School of Medicine, Tochigi, Japan
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Chu J, Zhou Z, Hong G, Guan J, Li S, Rao L, Meng Q, Yang Z. High-resolution MRI of the intraparotid facial nerve based on a microsurface coil and a 3D reversed fast imaging with steady-state precession DWI sequence at 3T. AJNR Am J Neuroradiol 2013; 34:1643-8. [PMID: 23578676 DOI: 10.3174/ajnr.a3472] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE 3D high-resolution MR imaging can provide reliable information for defining the exact relationships between the intraparotid facial nerve and adjacent structures. The purpose of this study was to explore the clinical value of using a surface coil combined with a 3D-PSIF-DWI sequence in intraparotid facial nerve imaging. MATERIALS AND METHODS Twenty-one healthy volunteers underwent intraparotid facial nerve scanning at 3T by using the 3D-PSIF-DWI sequence with both the surface coil and the head coil. Source images were processed with MIP and MPR to better delineate the intraparotid facial nerve and its branches. In addition, the SIR of the facial nerve and parotid gland was calculated. The number of facial nerve branches displayed by these 2 methods was calculated and compared. RESULTS The display rates of the main trunk, divisions (cervicofacial, temporofacial), and secondary branches of the intraparotid facial nerve were 100%, 97.6%, and 51.4% by head coil and 100%, 100%, and 83.8% by surface coil, respectively. The display rate of secondary branches of the intraparotid facial nerve by these 2 methods was significantly different (P < .05). The SIRs of the intraparotid facial nerve/parotid gland in these 2 methods were significantly different (P < .05) at 1.37 ± 1.06 and 1.89 ± 0.87, respectively. CONCLUSIONS The 3D-PSIF-DWI sequence combined with a surface coil can better delineate the intraparotid facial nerve and its divisions than when it is combined with a head coil, providing better image contrast and resolution. The proposed protocol offers a potentially useful noninvasive imaging sequence for intraparotid facial nerve imaging at 3T.
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Affiliation(s)
- J Chu
- Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
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