Department of Diagnostic and Therapeutic Radiology, 432716Ramathibodi Hospital, Thailand.
Neuroradiol J. 2021 Apr;34(2):99-104. doi: 10.1177/1971400920970918. Epub 2020 Nov 11.
The aim of this study was to depict the signal intensity pattern of the normal oculomotor nerve demonstrated on contrast-enhanced three-dimensional fluid-attenuated inversion recovery images.
Eighty-one patients were included in the study. Contrast-enhanced three-dimensional fluid-attenuated inversion recovery images with magnetisation-prepared rapid acquisition were reconstructed and evaluated in the coronal plane. The signal intensity of the cisternal segment of the oculomotor nerve was graded into a visual scale of 1 to 5 as compared to the white matter, grey matter and the pituitary stalk. The signal intensity ratio of the oculomotor nerve was consequently measured.
By using the visual scale, more than half of the oculomotor nerves showed higher signal intensity than the grey matter signal on contrast-enhanced three-dimensional fluid-attenuated inversion recovery images (59.3-80.2%). It can demonstrate a signal intensity similar to the pituitary stalk (14.8%) by visualisation. None of them showed signal intensity equal to the normal white matter signal. By signal intensity measurement, the mean signal intensity ratio of oculomotor nerves to white matter equals 1.54±0.20 (95% confidence interval (CI) 1.51-1.57); mean signal intensity ratio to grey matter equals 1.16±0.15 (95% CI 1.14-1.18); mean signal intensity ratio to the pituitary stalk equals 0.68±0.10 (95% CI 0.64-0.70).
The normal oculomotor nerve visualised on contrast-enhanced three-dimensional fluid-attenuated inversion recovery images has a higher signal intensity than the white matter and may have a signal intensity similar to the grey matter or the pituitary stalk. The high signal intensity of the oculomotor nerve in contrast-enhanced three-dimensional fluid-attenuated inversion recovery should not be misinterpreted as a pathology.
本研究旨在描绘增强三维液体衰减反转恢复（contrast-enhanced three-dimensional fluid-attenuated inversion recovery，CE-3D-FLAIR）图像上正常动眼神经的信号强度模式。
本研究纳入 81 例患者。对冠状位 CE-3D-FLAIR 图像进行重建和评估，这些图像采用磁化准备快速采集技术。将动眼神经池段的信号强度与脑白质、灰质和垂体柄进行视觉评分，范围为 1 至 5 级。随后测量动眼神经的信号强度比值。
使用视觉评分，超过一半的动眼神经在 CE-3D-FLAIR 图像上显示出比灰质信号更高的信号强度（59.3%-80.2%）。通过可视化，可以显示出与垂体柄相似的信号强度（14.8%）。没有任何一个动眼神经的信号强度与正常脑白质信号相等。通过信号强度测量，动眼神经与脑白质的平均信号强度比值为 1.54±0.20（95%置信区间（confidence interval，CI）1.51-1.57）；与灰质的平均信号强度比值为 1.16±0.15（95%CI 1.14-1.18）；与垂体柄的平均信号强度比值为 0.68±0.10（95%CI 0.64-0.70）。
CE-3D-FLAIR 图像上可见的正常动眼神经信号强度高于脑白质，其信号强度可能与灰质或垂体柄相似。CE-3D-FLAIR 中动眼神经的高信号不应被误解为病理改变。
