Cassetta M, Pranno N, Pompa V, Barchetti F, Pompa G
Department of Oral and Maxillofacial Sciences, School of Dentistry, and Department of Radiological, Oncology and Anatomo-Pathological Sciences; "Sapienza" University of Rome, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2014;18(2):257-64.
The evaluation of the trigeminal course and his anatomical relationships with surrounding structures, is important for the assessment of the injury that may occur in tumors and several orofacial trauma and for avoiding the damage during surgeries.
The aim of this retrospective study was to assess the use of 3-T MRI in the evaluation of the course of the four segments of the trigeminal nerve: cisternal and Meckels's cave, cavernous sinus, skull base and mandibular extracranial segments.
78 patients were studied, for a total of 156 trigeminal nerves examined. T2-weighted 3D Fast imaging employing steady-state acquisition and T1-weighted Fast spoiled gradient recalled echo sequences were used. Two radiologists (reader A and B), independently, evaluated the course of the four segments of the trigeminal nerve according to a qualitative scale. The Intraclass correlation coefficient (ICC) and Pearson correlation coefficient were used to assess the intraobserver and interobserver variability in the nerve course evaluation.
Reader A evaluated 47 trigeminal nerves excellent, 94 good, 12 fair and 3 poor. Reader B rated 43 trigeminal nerves excellent, 92 good, 16 fair and 5 poor. The intraobserver variability was ICC = 0.937 in reader A and ICC = 0.894 in reader B. The interobserver variability was 0.734 (p ≤ 0.01).
High resolution 3-T MRI imaging allows an accurate study of the trigeminal nerve and especially of its mandibular branch. The knowledge of the course and of the anatomic relationships of these nerve bundles with surrounding structures, as well as of the anatomical variants, allow oral and maxillofacial surgical plannings thus reducing the risk of nerve damage.
评估三叉神经走行及其与周围结构的解剖关系，对于评估肿瘤及多种口腔颌面创伤中可能发生的损伤以及避免手术过程中的损伤至关重要。
本回顾性研究的目的是评估3-T磁共振成像（MRI）在评估三叉神经四个节段走行中的应用：脑池段和 Meckel 腔段、海绵窦段、颅底段及下颌骨颅外段。
对78例患者进行研究，共检查156条三叉神经。采用了T2加权三维稳态采集快速成像序列和T1加权快速扰相梯度回波序列。两位放射科医生（阅片者A和B）独立地根据定性标准评估三叉神经四个节段的走行。使用组内相关系数（ICC）和Pearson相关系数评估神经走行评估中的观察者内和观察者间变异性。
阅片者A评估47条三叉神经为优，94条为良，12条为中等，3条为差。阅片者B将43条三叉神经评为优，92条为良，16条为中等，5条为差。阅片者A的观察者内变异性为ICC = 0.937，阅片者B为ICC = 0.894。观察者间变异性为0.734（p≤0.01）。
高分辨率3-T MRI成像能够准确研究三叉神经，尤其是其下颌支。了解这些神经束的走行及其与周围结构的解剖关系以及解剖变异，有助于口腔颌面外科手术规划，从而降低神经损伤风险。
