Fujii H, Fujita A, Yang A, Kanazawa H, Buch K, Sakai O, Sugimoto H
From the Department of Radiology (H.F., A.F., H.K., H.S.), Jichi Medical University School of Medicine, Tochigi, Japan.
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.)
AJNR Am J Neuroradiol. 2015 Jul;36(7):1333-7. doi: 10.3174/ajnr.A4288. Epub 2015 Apr 2.
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.
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.
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).
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.
尽管随着磁共振成像技术的进步，颅神经颅外分支的可视化有所改善，但仅有有限的研究评估了下颌神经（V3）颅外分支的检测情况。我们采用水激发三维双回波稳态序列研究了V3分支的可检测性。
我们回顾性评估了86例连续接受水激发三维双回波稳态序列磁共振成像的患者中V3的6个分支，即咬肌神经、颊神经、耳颞神经、舌神经、下牙槽神经和下颌舌骨肌神经的可检测性，采用5分制（4分，优秀；3分，良好；2分，中等；1分，差；0分，未检测到）。采用加权κ分析计算3位阅片者之间的观察者间变异性。
舌神经和下牙槽神经的检测最为成功，平均得分分别为3.80分和3.99分，为优秀。咬肌神经、颊神经和耳颞神经的检测情况良好，平均得分分别为3.31分、2.67分和3.11分。下颌舌骨肌神经难以检测到，平均得分较差，为0.62分。所有神经在3位阅片者之间均具有优秀的观察者间变异性（平均加权κ值为0.95 - 1.00）。
水激发三维双回波稳态序列在大多数患者中显示出V3颅外分支的良好可视化。水激发三维双回波稳态序列在诊断V3病变以及术前识别周围颅神经以预防手术并发症方面具有潜力。
