From the Department of Radiology, Mayo Clinic, Jacksonville, Florida.
From the Department of Radiology, Mayo Clinic, Jacksonville, Florida
AJNR Am J Neuroradiol. 2023 Feb;44(2):186-191. doi: 10.3174/ajnr.A7774. Epub 2023 Jan 19.
The trochlear nerve has traditionally been difficult to identify on MR imaging. The advent of 7T MR imaging promises to greatly benefit visualization of small structures due to gains in the signal-to-noise ratio allowing improved spatial resolution. We investigated the utility of a clinically feasible ultra-high-resolution 7T MR imaging protocol for identification of the trochlear nerve, as well as assessment of normal trochlear nerve anatomy.
Coronal high-resolution 2D T2-weighted TSE images used in a 7T epilepsy protocol of 50 subjects at our institution were reviewed by 2 independent radiologists for visualization of the trochlear nerve at the nerve origin and cisternal, tentorial, and cavernous segments. The frequency of nerve visibility within these segments and their anatomy were documented, and disagreements were resolved by joint review.
Of the 100 nerves reviewed in 50 subjects, at least 2 segments of the trochlear nerve from the brainstem to the cavernous sinus were identified in 100% of cases. The origins from the brainstem and cisternal segment were visible in 65% and 93% of nerves, respectively. The trochlear nerve was identified at the trochlear groove in 100% of cases and in the posterior wall of the cavernous sinus in 74% of cases.
Coronal high-resolution 2D TSE at 7T reliably identified the trochlear nerve throughout its course and is a promising tool for imaging patients with suspected trochlear nerve pathology.
滑车神经在磁共振成像（MRI）中传统上难以识别。7T MRI 的出现有望极大地受益于小结构的可视化，因为信号噪声比的提高允许改善空间分辨率。我们研究了一种临床可行的超高分辨率 7T MR 成像方案在识别滑车神经以及评估正常滑车神经解剖结构方面的应用。
对我院 50 例患者的 7T 癫痫协议中使用的冠状位高分辨率 2D T2 加权 TSE 图像进行了回顾性分析，由 2 位独立的放射科医生评估滑车神经在神经起源、池段、天幕段和海绵窦段的可视化情况。记录了神经在这些节段内的可见频率及其解剖结构，并通过联合审查解决了分歧。
在 50 例患者的 100 条神经中，100%的病例至少能识别出从脑干到海绵窦的滑车神经的 2 个节段。从脑干起源和池段的神经分别有 65%和 93%可见。在 100%的病例中，滑车神经在滑车沟中被识别，在 74%的病例中在海绵窦的后壁中被识别。
7T 冠状位高分辨率 2D TSE 可靠地识别了滑车神经的全程，是一种很有前途的成像工具，可用于疑似滑车神经病变的患者。
