Department of Radiology and Biomedical Imaging, University of California San Francisco, 505 Parnassus Ave, San Francisco, CA, 94143, USA.
Radiology Associates, Springfield, OR, USA.
Neuroradiology. 2023 Oct;65(10):1425-1438. doi: 10.1007/s00234-023-03204-y. Epub 2023 Aug 4.
CT and MRI findings of tongue ptosis and atrophy should alert radiologists to potential pathology along the course of the hypoglossal nerve (cranial nerve XII), a purely motor cranial nerve which supplies the intrinsic and extrinsic muscles of the tongue. While relatively specific for hypoglossal nerve pathology, these findings do not accurately localize the site or cause of denervation. A detailed understanding of the anatomic extent of the nerve, which crosses multiple anatomic spaces, is essential to identify possible underlying pathology, which ranges from benign postoperative changes to life-threatening medical emergencies. This review will describe key imaging findings of tongue denervation, segmental anatomy of the hypoglossal nerve, imaging optimization, and comprehensive imaging examples of diverse pathology which may affect the hypoglossal nerve. Armed with this knowledge, radiologists will increase their sensitivity for detection of pathology and provide clinically relevant differential diagnoses when faced with findings of tongue ptosis and denervation.
CT 和 MRI 发现舌下垂和萎缩，应引起放射科医生对舌下神经（颅神经 XII）沿程潜在病变的警惕，舌下神经是唯一供应舌内、外肌的纯运动颅神经。虽然这些发现对舌下神经病变具有相对特异性，但并不能准确定位失神经的部位或原因。详细了解神经的解剖范围至关重要，因为神经穿过多个解剖间隙，这有助于识别可能的潜在病变，从良性术后改变到危及生命的医学急症都有可能。本文将描述舌失神经支配的关键影像学表现、舌下神经的节段解剖、影像学优化以及可能影响舌下神经的多种病变的综合影像学示例。有了这些知识，放射科医生在发现舌下垂和失神经支配时，将提高对病变的敏感性，并提供有临床意义的鉴别诊断。
