Visualization of the Extracranial Branches of the Trigeminal Nerve Using Improved Motion-Sensitized Driven Equilibrium-Prepared 3D Inversion Recovery TSE Sequence.

Background and purpose: 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.

Materials and 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.