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KMID : 1161920190160010001
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Journal of Medicine and Life Science
2019 Volume.16 No. 1 p.1 ~ p.5
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MR Diagnosis of Cranial Neuritis focusing on Facial Neuritis: Performance of Contrast-Enhanced 3D-FLAIR Technique
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Lee Ho-Kyu
Koh Myeong-Ju
Kim Seung-Hyoung
Oh Jung-Hwan
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Abstract
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Purpose: Our purpose was to retrospectively evaluate usefulness of the contrast-enhanced 3D-FLAIR technique of half brain volume to diagnose the patients with facial neuritis based on segment-based analysis.
Materials and Methods: We assessed 17 consecutive patients who underwent brain MR imaging at 3 tesla for facial neuritis: 11 patients with idiopathic facial neuritis and 6 with herpes zoster oticus. Contrast enhanced 3D-FLAIR sequences of the half brain volume were analyzed and 3D T1-weighted sequence of the full brain volume were used as the base-line exam. Enhancement of the facial nerve was determined in each segment of 5 facial nerve segments by two radiologists. Sensitivity, specificity and accuracy of enhancement of each segment were assessed. The authors experienced a prompt fuzzy CSF enhancement in the fundus of the internal auditory canal in patients with enhancement of the canalicular segment.
Results: Interobserver agreement of CE 3D-FLAIR was excellent(κ-value 0.885). Sensitivity, specificity, and accuracy of each segment are 1.0, 0.823, 0.912 in the canalicular segment; 0.118, 1.0, 0.559 in the labyrinthine segment; 0.823, 0.294, 0.559 in the anterior genu; 0.823, 0.529, 0.676 in the tympanic segment; 0.823, 0.235, 0.529 in the mastoid segment, respectively. In addition, those of prompt fuzzy enhancement were 0.647, 1.0, and 0.824, respectively. Incidence of prompt fuzzy enhancement with enhancement of the canalicular segment was 11sites(55%): 6(54.5%) in idiopathic facial neuritis and 5(83.3%) in herpes zoster. Enhancement of the canalicular segment and prompt fuzzy enhancement on CE 3D FLAIR was significantly correlated with occurrence of facial neuritis(p<0.001).
Conclusion: CE 3D-FLAIR technique of the half brain volume is useful to evaluate the patients with facial neuritis as an adjunct sequence in addition to CE 3D T1WS. On segment-based analysis, contrast enhancement of the canalicular segment is the most reliable. Prompt fuzzy enhancement is seen in not only herpes zoster, but in idiopathic facial neuritis.
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KEYWORD
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Bell’s palsy, Herpes zoster oticus, Cranial neuritis, MRI, Facial nerve
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