目的:颅外三叉神经的可视化对于检测神经病理学改变至关重要。本研究旨在使用具有改进的运动敏化驱动平衡(iMSDE)脉冲的3D反转恢复TSE评估颅外三叉神经的可视化。
方法:在这项前瞻性研究中,35名受试者使用常规3D反转恢复TSE对三叉神经进行了成像,使用iMSDE脉冲的3D反演恢复TSE,和对比度增强的3D反演恢复TSE。三叉神经的7个颅外分支的可见性,静脉/肌肉抑制,神经和病变之间的关系的识别在5分制评分。此外,SNR,神经-肌肉对比度,神经-静脉对比比,神经-肌肉对比噪声比,计算并比较神经-静脉对比噪声比。
结果:使用iMSDE3D反转恢复TSE获得的图像具有明显更高的神经-肌肉对比度,神经-静脉对比比,和神经-静脉对比噪声比(所有P<.001);与传统的3D反转恢复TSE相比,改善了静脉/肌肉抑制,并且除了眼神经之外的三叉神经分支的可视化更清晰(所有P<.05)。与对比增强的3D反演恢复TSE相比,用iMSDE三维反演恢复TSE采集的图像具有明显更高的信噪比,神经-肌肉对比度,和神经静脉对比噪声比(所有P<0.05),并证明上颌神经的诊断质量相当(评分≥3),下颌神经,下牙槽神经,舌神经,和咬神经(P>0.05)。至于神经与病变关系的鉴定,iMSDE3D反转恢复TSE在这3个序列中显示最高得分(所有P<.05)。
结论:在临床实践中,iMSDE3D反转恢复TSE是传统3D反转恢复TSE和对比增强3D反转恢复TSE的有希望的替代方案,用于显示三叉神经的颅外分支。
OBJECTIVE: Visualization of the extracranial trigeminal nerve is crucial to detect nerve pathologic alterations. This study aimed to evaluate visualization of the extracranial trigeminal nerve using 3D inversion recovery TSE with an improved motion-sensitized driven equilibrium (iMSDE) pulse.
METHODS: In this prospective study, 35 subjects underwent imaging of the trigeminal nerve using conventional 3D inversion recovery TSE, 3D inversion recovery TSE with an iMSDE pulse, and contrast-enhanced 3D inversion recovery TSE. The visibility of 7 extracranial branches of the trigeminal nerve, venous/muscle suppression, and identification of the relationship between nerves and lesions were scored on a 5-point scale system. In addition, SNR, nerve-muscle contrast ratio, nerve-venous contrast ratio, nerve-muscle contrast-to-noise ratio, and nerve-venous contrast-to-noise ratio were calculated and compared.
RESULTS: Images acquired with iMSDE 3D inversion recovery TSE had significantly higher nerve-muscle contrast ratio, nerve-venous contrast ratio, and nerve-to-venous contrast-to-noise ratio (all P < .001); improved venous/muscle suppression and clearer visualization of the trigeminal nerve branches except the ophthalmic nerve than with conventional 3D inversion recovery TSE (all P < .05). Compared with contrast-enhanced 3D inversion recovery TSE, images acquired with iMSDE 3D inversion recovery TSE had significantly higher SNR, nerve-muscle contrast ratio, and nerve-to-venous contrast-to-noise ratio (all P < .05), and demonstrated comparable diagnostic quality (scores ≥3) of the maxillary nerve, mandibular nerve, inferior alveolar nerve, lingual nerve, and masseteric nerve (P > .05). As for the identification of the relationship between nerves and lesions, iMSDE 3D inversion recovery TSE showed the highest scores among these 3 sequences (all P < .05).
CONCLUSIONS: The iMSDE 3D inversion recovery TSE is a promising alternative to conventional 3D inversion recovery TSE and contrast-enhanced 3D inversion recovery TSE for visualization of the extracranial branches of trigeminal nerve in clinical practice.