Skip to main content
Erschienen in: Clinical Neuroradiology 1/2017

06.06.2015 | Original Article

Visualization of the Abducens Nerve in its Petroclival Segment Using Contrast-Enhanced FIESTA MRI: The Size of the Petroclival Venous Confluence Affects Detectability

verfasst von: A. Özgür, K. Esen, E. Kara, G. O. Temel

Erschienen in: Clinical Neuroradiology | Ausgabe 1/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Visualization of the abducens nerve in its petroclival segment still remains challenging. We aimed to investigate the detectability of the petroclival segment of the abducens nerve and to evaluate the role of the size of the petroclival venous confluence (PVC) in the visibility of the nerve using contrast-enhanced fast imaging employing steady-state acquisition (FIESTA) magnetic resonance imaging (MRI).

Methods

We retrospectively evaluated the contrast-enhanced FIESTA images of 237 patients (female/male: 127/110; mean age: 49.0 ± 14.7). Two radiologists divided the imaging findings of the petroclival segments of the abducens nerves into three groups: 0 (not visualized), 1 (partially visualized), and 2 (completely visualized). Another radiologist measured the anteroposterior diameter of the PVC from the clival bony surface to the inner layer of dura at the dural entrance level of the abducens nerve. One-way analysis of variance, Tukey’s test, and receiving operating curve analysis were performed.

Results

Among 474 abducens nerves, 76 were classified as group 0 (76/474, 16.03 %), 100 were classified as group 1 (100/474, 21.10 %), and 298 were classified as group 2 (298/474, 62.87 %). There was significant difference in mean anteroposterior diameters of the PVC for each group (group 0, 0.95 mm; group 1, 1.80 mm; group 2, 2.51 mm). The cut-off values for the differentiation of group 0 from group 1 and group 1 from group 2 were found to be 1.35 and 2.09 mm, respectively.

Conclusions

Abducens nerve in its petroclival segment can be reliably identified using contrast-enhanced FIESTA MRI especially in those with a greater anteroposterior diameter of the PVC.
Literatur
1.
Zurück zum Zitat Iocenatta G, Fusco M, Cavallo LM, Cappabianca P, Samii M, Tschabitscher M. The abducens nerve: microanatomic and endoscopic study. Neurosurgery. 2007;61:7–14. Iocenatta G, Fusco M, Cavallo LM, Cappabianca P, Samii M, Tschabitscher M. The abducens nerve: microanatomic and endoscopic study. Neurosurgery. 2007;61:7–14.
2.
Zurück zum Zitat Joo W, Yoshioka F, Funaki T, Rhoton AL, Jr. Microsurgical anatomy of the abducens nerve. Clin Anat. 2012;25:1030–42.CrossRefPubMed Joo W, Yoshioka F, Funaki T, Rhoton AL, Jr. Microsurgical anatomy of the abducens nerve. Clin Anat. 2012;25:1030–42.CrossRefPubMed
3.
Zurück zum Zitat Tsitsopoulos PD, Tsonidis CA, Petsas GP, Hadjiioannou PN, Njau SN, Anagnostopoulos IV. Microsurgical study of the Dorello’s canal. Skull Base Surg. 1996;6:181–5.CrossRefPubMedPubMedCentral Tsitsopoulos PD, Tsonidis CA, Petsas GP, Hadjiioannou PN, Njau SN, Anagnostopoulos IV. Microsurgical study of the Dorello’s canal. Skull Base Surg. 1996;6:181–5.CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Ozveren MF, Sam B, Akdemir I, Alkan A, Tekdemir I, Deda H. Duplication of the abducens nerve at the petroclival region: an anatomic study. Neurosurgery. 2003;52:645–52.CrossRefPubMed Ozveren MF, Sam B, Akdemir I, Alkan A, Tekdemir I, Deda H. Duplication of the abducens nerve at the petroclival region: an anatomic study. Neurosurgery. 2003;52:645–52.CrossRefPubMed
5.
Zurück zum Zitat Destrieux C, Velut S, Kakou MK, Lefrancq T, Arbeille B, Santini JJ. A new concept in Dorello’s canal microanatomy: the petroclival venous confluence. J Neurosurg. 1997;87:67–72.CrossRefPubMed Destrieux C, Velut S, Kakou MK, Lefrancq T, Arbeille B, Santini JJ. A new concept in Dorello’s canal microanatomy: the petroclival venous confluence. J Neurosurg. 1997;87:67–72.CrossRefPubMed
6.
Zurück zum Zitat Chavhan GB, Babyn PS, Jankharia BG, Cheng HL, Shroff MM. Steady-state MR imaging sequences: physics, classification, and clinical applications. Radiographics. 2008;28:1147–60.CrossRefPubMed Chavhan GB, Babyn PS, Jankharia BG, Cheng HL, Shroff MM. Steady-state MR imaging sequences: physics, classification, and clinical applications. Radiographics. 2008;28:1147–60.CrossRefPubMed
7.
Zurück zum Zitat Sheth S, Branstetter BF, IV, Escott EJ. Appearance of normal cranial nerves on steady-state free precession MR images. Radiographics. 2009;29:1045–55.CrossRefPubMed Sheth S, Branstetter BF, IV, Escott EJ. Appearance of normal cranial nerves on steady-state free precession MR images. Radiographics. 2009;29:1045–55.CrossRefPubMed
8.
Zurück zum Zitat Yousry I, Moriggl B, Schmid UD, Wiesmann M, Fesl G, Brückmann H, Naidich TP, Yousry TA. Detailed anatomy of the intracranial segment of the hypoglossal nerve: neurovascular relationships and landmarks on magnetic resonance imaging sequences. J Neurosurg. 2002;96:1113–22.CrossRefPubMed Yousry I, Moriggl B, Schmid UD, Wiesmann M, Fesl G, Brückmann H, Naidich TP, Yousry TA. Detailed anatomy of the intracranial segment of the hypoglossal nerve: neurovascular relationships and landmarks on magnetic resonance imaging sequences. J Neurosurg. 2002;96:1113–22.CrossRefPubMed
9.
Zurück zum Zitat Linn J, Peters F, Moriggl B, Naidich TP, Brückmann H, Yousry I. The jugular foramen: imaging strategy and detailed anatomy at 3 T. AJNR Am J Neuroradiol. 2009;30:34–41.CrossRefPubMed Linn J, Peters F, Moriggl B, Naidich TP, Brückmann H, Yousry I. The jugular foramen: imaging strategy and detailed anatomy at 3 T. AJNR Am J Neuroradiol. 2009;30:34–41.CrossRefPubMed
10.
Zurück zum Zitat Yousry I, Camelio S, Wiesmann M, Schmid UD, Moriggl B, Brückmann H, Yousry TA. Detailed magnetic resonance imaging anatomy of the cisternal segment of the abducens nerve: Dorello’s canal and neurovascular relationships and landmarks. J Neurosurg. 1999;91:276–83.CrossRefPubMed Yousry I, Camelio S, Wiesmann M, Schmid UD, Moriggl B, Brückmann H, Yousry TA. Detailed magnetic resonance imaging anatomy of the cisternal segment of the abducens nerve: Dorello’s canal and neurovascular relationships and landmarks. J Neurosurg. 1999;91:276–83.CrossRefPubMed
11.
Zurück zum Zitat Yousry I, Camelio S, Schmid UD, Horsfield MA, Wiesmann M, Brückmann H, Yousry TA. Visualization of cranial nerves I-XII: value of 3D CISS and T2-weighted FSE sequences. Eur Radiol. 2000;10:1061–7.CrossRefPubMed Yousry I, Camelio S, Schmid UD, Horsfield MA, Wiesmann M, Brückmann H, Yousry TA. Visualization of cranial nerves I-XII: value of 3D CISS and T2-weighted FSE sequences. Eur Radiol. 2000;10:1061–7.CrossRefPubMed
12.
Zurück zum Zitat Yagi A, Sato N, Taketomi A, Nakajima T, Morita H, Koyama Y, Aoki J, Endo K. Normal cranial nerves in the cavernous sinuses: contrast-enhanced three dimensional constructive interference in the steady state MR imaging. AJNR Am J Neuroradiol. 2005;26:946–50.PubMed Yagi A, Sato N, Taketomi A, Nakajima T, Morita H, Koyama Y, Aoki J, Endo K. Normal cranial nerves in the cavernous sinuses: contrast-enhanced three dimensional constructive interference in the steady state MR imaging. AJNR Am J Neuroradiol. 2005;26:946–50.PubMed
13.
Zurück zum Zitat Hatipoğlu HG, Durakoğlugil T, Ciliz D, Yüksel E. Comparison of FSE T2W and 3D FIESTA sequences in the evaluation of posterior fossa cranial nerves with MR cisternography. Diagn Interv Radiol. 2007;13:56–60.PubMed Hatipoğlu HG, Durakoğlugil T, Ciliz D, Yüksel E. Comparison of FSE T2W and 3D FIESTA sequences in the evaluation of posterior fossa cranial nerves with MR cisternography. Diagn Interv Radiol. 2007;13:56–60.PubMed
14.
Zurück zum Zitat Amemiya S, Aoki S, Ohtomo K. Cranial nerve assessment in cavernous sinus tumors with contrast-enhanced 3D fast-imaging employing steady-state acqusition MR imaging. Neuroradiology. 2009;51:467–70.CrossRefPubMed Amemiya S, Aoki S, Ohtomo K. Cranial nerve assessment in cavernous sinus tumors with contrast-enhanced 3D fast-imaging employing steady-state acqusition MR imaging. Neuroradiology. 2009;51:467–70.CrossRefPubMed
15.
Zurück zum Zitat Yagi A, Sato N, Takahashi A, Morita H, Amanuma M, Endo K, Takeuchi K. Added value of contrast-enhanced CISS imaging in relation to conventional MR images for the evaluation of intracavernous cranial nerve lesions. Neuroradiology. 2010;52:1101–9.CrossRefPubMed Yagi A, Sato N, Takahashi A, Morita H, Amanuma M, Endo K, Takeuchi K. Added value of contrast-enhanced CISS imaging in relation to conventional MR images for the evaluation of intracavernous cranial nerve lesions. Neuroradiology. 2010;52:1101–9.CrossRefPubMed
16.
Zurück zum Zitat Alkan A, Sigirci A, Ozveren MF, Kutlu R, Altinok T, Onal C, Sarac K. The cisternal segment of the abducens nerve in man: three-dimensional MR imaging. Eur J Radiol. 2004;51:218–22.CrossRefPubMed Alkan A, Sigirci A, Ozveren MF, Kutlu R, Altinok T, Onal C, Sarac K. The cisternal segment of the abducens nerve in man: three-dimensional MR imaging. Eur J Radiol. 2004;51:218–22.CrossRefPubMed
17.
Zurück zum Zitat Ono K, Arai H, Endo T, Tsunoda A, Sato K, Sakai T, Makita J. Detailed MR imaging anatomy of the abducent nerve: evagination of CSF into Dorello canal. AJNR Am J Neuroradiol. 2004;25:623–6.PubMed Ono K, Arai H, Endo T, Tsunoda A, Sato K, Sakai T, Makita J. Detailed MR imaging anatomy of the abducent nerve: evagination of CSF into Dorello canal. AJNR Am J Neuroradiol. 2004;25:623–6.PubMed
18.
Zurück zum Zitat Ozveren MF, Erol FS, Alkan A, Kocak A, Onal C, Türe U. Microanatomical architecture of Dorello’s canal and its clinical implications. Neurosurgery. 2007;60:1–8.CrossRef Ozveren MF, Erol FS, Alkan A, Kocak A, Onal C, Türe U. Microanatomical architecture of Dorello’s canal and its clinical implications. Neurosurgery. 2007;60:1–8.CrossRef
19.
Zurück zum Zitat Blitz AM, Macedo LL, Chonka ZD, Ilica AT, Choudhri AF, Gallia GL, Aygun N. High resolution CISS MR imaging with and without contrast for evaluation of the upper cranial nerves: segmental anatomy and selected pathologic conditions of the cisternal through extraforaminal segments. Neuroimaging Clin N Am. 2014;24:17–34.CrossRefPubMed Blitz AM, Macedo LL, Chonka ZD, Ilica AT, Choudhri AF, Gallia GL, Aygun N. High resolution CISS MR imaging with and without contrast for evaluation of the upper cranial nerves: segmental anatomy and selected pathologic conditions of the cisternal through extraforaminal segments. Neuroimaging Clin N Am. 2014;24:17–34.CrossRefPubMed
20.
Zurück zum Zitat Iaconetta G, Fusco M, Samii M. The sphenopetroclival venous gulf: a microanatomical study. J Neurosurg. 2003;99:366–75.CrossRefPubMed Iaconetta G, Fusco M, Samii M. The sphenopetroclival venous gulf: a microanatomical study. J Neurosurg. 2003;99:366–75.CrossRefPubMed
21.
Zurück zum Zitat Kshettry VR, Lee JH, Ammirati M. The Dorello canal: historical development, contraversies in microsurgical anatomy, and clinical implications. Neurosurg Focus. 2013;34:E4.CrossRefPubMed Kshettry VR, Lee JH, Ammirati M. The Dorello canal: historical development, contraversies in microsurgical anatomy, and clinical implications. Neurosurg Focus. 2013;34:E4.CrossRefPubMed
22.
Zurück zum Zitat Ozveren MF, Uchida K, Aiso S, Kawase T. Meningovenous structures of the petroclival region: clinical importance for surgery and intravascular surgery. Neurosurgery. 2002;50:829–36.CrossRefPubMed Ozveren MF, Uchida K, Aiso S, Kawase T. Meningovenous structures of the petroclival region: clinical importance for surgery and intravascular surgery. Neurosurgery. 2002;50:829–36.CrossRefPubMed
23.
Zurück zum Zitat Tubbs RS, Hansasuta A, Loukas M, Louis RG, Jr., Shoja MM, Salter EG, Oakes WJ. The basilar venous plexus. Clin Anat. 2007;20:755–9.CrossRefPubMed Tubbs RS, Hansasuta A, Loukas M, Louis RG, Jr., Shoja MM, Salter EG, Oakes WJ. The basilar venous plexus. Clin Anat. 2007;20:755–9.CrossRefPubMed
Metadaten
Titel
Visualization of the Abducens Nerve in its Petroclival Segment Using Contrast-Enhanced FIESTA MRI: The Size of the Petroclival Venous Confluence Affects Detectability
verfasst von
A. Özgür
K. Esen
E. Kara
G. O. Temel
Publikationsdatum
06.06.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Neuroradiology / Ausgabe 1/2017
Print ISSN: 1869-1439
Elektronische ISSN: 1869-1447
DOI
https://doi.org/10.1007/s00062-015-0415-x

Weitere Artikel der Ausgabe 1/2017

Clinical Neuroradiology 1/2017 Zur Ausgabe

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.