MR-Neurography of the facial nerve in parotid tumors: intra-parotid nerve visualization and surgical correlation.

IF 2.4 3区 医学 Q2 CLINICAL NEUROLOGY Neuroradiology Pub Date : 2024-10-01 Epub Date: 2024-05-08 DOI:10.1007/s00234-024-03372-5
Chiara Gaudino, Andrea Cassoni, Martina Lucia Pisciotti, Resi Pucci, Angela Palma, Nicoletta Fantoni, Patrizia Pantano, Valentino Valentini
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Abstract

Purpose: One of the most severe complications in surgery of parotid tumors is facial palsy. Imaging of the intra-parotid facial nerve is challenging due to small dimensions. Our aim was to assess, in patients with parotid tumors, the ability of high-resolution 3D double-echo steady-state sequence with water excitation (DE3D-WE) (1) to visualize the extracranial facial nerve and its tracts, (2) to evaluate their relationship to the parotid lesion and (3) to compare MRI and surgical findings.

Methods: A retrospective study was conducted including all patients with parotid tumors, who underwent MRI from April 2022 to December 2023. Two radiologists independently reviewed DE3D-WE images, assessing quality of visualization of the facial nerve bilaterally and localizing the nerve's divisions in relation to the tumor. MRI data were compared with surgical findings.

Results: Forty consecutive patients were included (M:F = 22:18; mean age 56.3 ± 17.4 years). DE3D-WE could excellently visualize the nerve main trunk and the temporofacial division in all cases. The cervicofacial branch was visible in 99% of cases and visibility was good. Distal divisions were displayed in 34% of cases with a higher visibility on the tumor side (p < 0.05). Interrater agreement was high (weighted kappa 0.94 ± 0.01 [95% CI 0.92-0.97]). Compared to surgery accuracy of MRI in localizing the nerve was 100% for the main trunk, 96% for the temporofacial and 89% for the cervicofacial branches.

Conclusions: Facial nerve MR-neurography represents a reliable tool. DE3D-WE can play an important role in surgical planning of patients with parotid tumors, reducing the risk of nerve injury.

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腮腺肿瘤面神经的磁共振神经显像:腮腺内神经显像和手术相关性。
目的:腮腺肿瘤手术中最严重的并发症之一是面瘫。由于腮腺内面神经的尺寸较小,对其进行成像具有挑战性。我们的目的是评估高分辨率三维双回波稳态序列与水激发(DE3D-WE)在腮腺肿瘤患者中(1)观察颅外面神经及其束的能力;(2)评估它们与腮腺病变的关系;(3)比较核磁共振成像和手术结果:回顾性研究包括2022年4月至2023年12月期间接受磁共振成像检查的所有腮腺肿瘤患者。两名放射科医生独立审查 DE3D-WE 图像,评估双侧面神经的显像质量,并定位面神经与肿瘤的分界。核磁共振成像数据与手术结果进行比较:共纳入 40 例连续患者(男:女=22:18;平均年龄 56.3 ± 17.4 岁)。在所有病例中,DE3D-WE都能很好地显示神经主干和颞面部分支。99%的病例可以看到颈面部分支,可视性良好。34%的病例显示了远端分部,肿瘤一侧的可见度更高(P面神经磁共振神经影像学是一种可靠的工具。DE3D-WE 可在腮腺肿瘤患者的手术规划中发挥重要作用,降低神经损伤的风险。
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来源期刊
Neuroradiology
Neuroradiology 医学-核医学
CiteScore
5.30
自引率
3.60%
发文量
214
审稿时长
4-8 weeks
期刊介绍: Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.
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