Preoperative detection of the facial nerve by high-field magnetic resonance imaging in patients with vestibular schwannoma
Preoperative detection of the facial nerve by high-field magnetic resonance imaging in patients with vestibular schwannoma
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DOI：
10.1007/s00234-013-1156-7
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发表时间：
2013-05-01
期刊：
影响因子：
2.8
通讯作者：
Kohmura, Eiji
中科院分区：
文献类型：
--
作者：
Nakai, Tomoaki;Yamamoto, Hirotaka;Kohmura, Eiji
术前了解面神经相对于前庭神经鞘瘤的位置将非常有助于决定适应的治疗策略。本研究的目的是评估利用3t高分辨率磁共振脑池造影预测前庭神经鞘瘤患者面神经病程的可行性。本研究对82例前庭神经鞘瘤手术患者进行了前瞻性研究。所有患者术前均行钆（Gd）增强、平衡快速场回声（bFFE）成像。术前估计面神经走行，结果与术中所见相吻合。术前MRI可识别面神经38例（46.3%）。在28例（34.1%的总患者，73.7%的确诊患者）中，mri识别的面神经病程与术中表现完全一致。在mri识别面神经的患者组中，肿瘤体积较小，实型数量较多。肿瘤呈实性且小于20mm者23例。其中19例（82.6%）能预估面神经，16例（69.6%）完全吻合。gd增强的3 T bFFE能够显示手术前前庭神经鞘瘤患者面神经的位置。除了轴向图像外，垂直于内耳道的切片也是有用的。在小的实体型肿瘤中，面神经比其他类型的肿瘤更容易被识别。
Preoperative knowledge of the position of the facial nerve relative to a vestibular schwannoma would be very helpful to decide for an adapted therapeutic strategy. The aim of this study is to assess the feasibility of predicting the course of the facial nerve in vestibular schwannoma patients using 3 T high-resolution magnetic resonance cisternography in a large consecutive series.The study was prospectively conducted in 82 patients operated for vestibular schwannoma. All patients underwent preoperative gadolinium (Gd)-enhanced, balanced fast-field echo (bFFE) imaging. The course of the facial nerve was estimated preoperatively and the results were verified with the intraoperative findings.The facial nerve could be identified by preoperative MRI in 38 cases (46.3 %). In 28 cases (34.1 % of total patients, 73.7 % of identified patients), the course of the MRI-identified facial nerve was completely congruent with the intraoperative findings. In the patient group with MRI-identified facial nerves, tumor size was smaller and the number of solid type was larger. There were 23 cases where the tumor was solid and smaller than 20 mm. Nineteen (82.6 %) of those cases could estimate the facial nerve preoperatively and 16 cases (69.6 %) have complete congruency.Gd-enhanced bFFE at 3 T is capable of demonstrating the location of the facial nerve in vestibular schwannoma patients prior to surgery. Slices that were perpendicular to the internal auditory canal were useful besides axial images. In small, solid-type tumors, facial nerve was more easily identified than other types of tumors.