Kwon Dohyun, Lee Chena, Chae YeonSu, Kwon Ik Jae, Kim Soung Min, Lee Jong-Ho
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.
Imaging Sci Dent. 2022 Sep;52(3):259-266. doi: 10.5624/isd.20220035. Epub 2022 May 13.
This study aimed to evaluate the clinical usefulness of magnetic resonance (MR) neurography using the 3-dimensional double-echo steady-state with water excitation (3D-DESS-WE) sequence for the preoperative delineation of the facial and lingual nerves.
Patients underwent MR neurography for a tumor in the parotid gland area or lingual neuropathy from January 2020 to December 2021 were reviewed. Preoperative MR neurography using the 3D-DESS-WE sequence was evaluated. The visibility of the facial nerve and lingual nerve was scored on a 5-point scale, with poor visibility as 1 point and excellent as 5 points. The facial nerve course relative to the tumor was identified as superficial, deep, or encased. This was compared to the actual nerve course identified during surgery. The operative findings in lingual nerve surgery were also described.
Ten patients with parotid tumors and 3 patients with lingual neuropathy were included. Among 10 parotid tumor patients, 8 were diagnosed with benign tumors and 2 with malignant tumors. The median facial nerve visibility score was 4.5 points. The distribution of scores was as follows: 5 points in 5 cases, 4 points in 1 case, 3 points in 2 cases, and 2 points in 2 cases. The lingual nerve continuity score in the affected area was lower than in the unaffected area in all 3 patients. The average visibility score of the lingual nerve was 2.67 on the affected side and 4 on the unaffected side.
This study confirmed that the preoperative localization of the facial and lingual nerves using MR neurography with the 3D-DESS-WE sequence was feasible and contributed to surgical planning for the parotid area and lingual nerve.
本研究旨在评估使用三维双回波稳态水激发（3D-DESS-WE）序列的磁共振（MR）神经成像在术前描绘面神经和舌神经方面的临床实用性。
回顾了2020年1月至2021年12月因腮腺区肿瘤或舌神经病变接受MR神经成像检查的患者。对使用3D-DESS-WE序列进行的术前MR神经成像进行评估。面神经和舌神经的可视性采用5分制评分，可视性差为1分，极佳为5分。确定面神经相对于肿瘤的走行为浅表、深部或包绕。将其与手术中确定的实际神经走行进行比较。还描述了舌神经手术的手术结果。
纳入10例腮腺肿瘤患者和3例舌神经病变患者。在10例腮腺肿瘤患者中，8例诊断为良性肿瘤，2例为恶性肿瘤。面神经可视性评分中位数为4.5分。评分分布如下：5分5例，4分1例，3分2例，2分2例。所有3例患者患侧舌神经连续性评分均低于未患侧。患侧舌神经平均可视性评分为2.67分，未患侧为4分。
本研究证实，使用3D-DESS-WE序列的MR神经成像术前定位面神经和舌神经是可行的，有助于腮腺区和舌神经的手术规划。
