MR imaging of the cisternal segment of the posterior group of cranial nerves: Neurovascular relationships and abnormal changes

Liang, Changhu; Du, Yinglin; Xu, Jinfa; Wu, Lebin; Liu, Cheng; Wang, Ximing; Wang, Haiyan; Yu, Fuhua

doi:10.1016/j.ejrad.2009.03.036

« Previous Next »European Journal of Radiology
Volume 75, Issue 1 , Pages 57-63, July 2010

MR imaging of the cisternal segment of the posterior group of cranial nerves: Neurovascular relationships and abnormal changes

Changhu Liang
- Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong, PR China
- Tel.: +86 13969133169.
Yinglin Du
- Shandong Provincial Center for Disease Control and Prevention, Public Health Institute, 72, Jingshi Road, Jinan, Shandong, PR China
- Tel.: +86 531 82679711.
Jinfa Xu
- Liao Cheng City People's Hospital, Dongchang Road, Liaocheng, Shandong, PR China
- Tel.: +86 531 87180889.
Lebin Wu
- Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong, PR China
- Tel.: +86 531 85186723.
Cheng Liu
- Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong, PR China
- Tel.: +86 531 85186723.
Ximing Wang
- Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong, PR China
- Tel.: +86 531 85186723.
Haiyan Wang
- Shandong University, Shandong Medical Imaging Research Institute, CT Room, 324, Jingwu Road, Jinan, Shandong, PR China
- Tel.: +86 531 85186723.
Fuhua Yu
- Weifang Medical College, 7166, West Road Baotong Weifang, Shandong, PR China
- Corresponding author. Tel.: +86 536 2602082.

Received 12 October 2008; received in revised form 17 March 2009; accepted 18 March 2009.

Abstract

Objective

To evaluate the detailed anatomic features, neurovascular relationships of the cisternal segment of the posterior group of cranial nerves (PGCN: IX, X, XI, XII); to evaluate the utility of magnetic resonance (MR) in demonstrating the PGCN with disorders caused by abnormal compression related to artery or tumor.

Methods

A total of 59 volunteers, 12 patients with abnormal symptom in the PGCN underwent three-dimensional (3D) Fourier transformation constructive interference in steady-state (CISS) MR imaging, and 22 of these volunteers and 12 patients also underwent MR angiography in which a time-of-flight (TOF) sequence was used to further distinguish the PGCN from the adjacent blood vessels. Anatomical features, neurovascular relationships of the PGCN in 59 volunteers and abnormal changes in 12 patients caused by neurovascular compression or tumor were observed from multi-planar reconstruction (MPR) images, cryomicrotome section and 3D-CISS MR imaging of cranial cadaver were used to testify the PGCN displayed in 59 volunteers.

Results

3D-CISS MR imaging depicted the proximal cisternal segment of the cranial nerves complex (CN IX, X, XI) at the oblique axial, sagittal planes in 100% (118/118), 99% (117/118) of 118 sides; CNXII in the oblique axial, sagittal planes in 90% (106/118), 91% (107/118) of 118 sides. At the sagittal planes, the CN IX, X, XI were found parallel to each other in the cisternal segment in 45.2% (53/117) of 117 sides, gathering into a bundle of nerves complex before entering the jugular foramen (JF) in 54.7% (64/117) of 117sides. VAs were blood vessels more often identified, they were found to be in contact with the PGCN in 28.0% (33/118) of 118 sides, and not in contact in 72.0% (85/118) of 118 sides. 3D-CISS MR imaging of volunteers revealed the similar result corresponding to cryomicrotome section and 3D-CISS MR imaging of cranial cadaver. Twelve patients with abnormal changes in the PGCN were all displayed well, among them 8 were pressed by arteries, 1 by arachnoid cyst, and 3 caused by tumors.

Conclusion

Use of 3D-CISS sequence enables accurate identification of the cisternal segment of the PGCN, neurovascular relationships and abnormal changes caused by neurovascular compression or tumor.

Keywords: The posterior group of cranial nerves, Magnetic resonance imaging, Neurovascular relationship, Multi-planar reconstruction