Skip to main content

Advertisement

Log in

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

  • Original Article
  • Published:
Clinical Neuroradiology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Iocenatta G, Fusco M, Cavallo LM, Cappabianca P, Samii M, Tschabitscher M. The abducens nerve: microanatomic and endoscopic study. Neurosurgery. 2007;61:7–14.

    Google Scholar 

  2. Joo W, Yoshioka F, Funaki T, Rhoton AL, Jr. Microsurgical anatomy of the abducens nerve. Clin Anat. 2012;25:1030–42.

    Article  PubMed  Google Scholar 

  3. 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.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. 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.

    Article  PubMed  Google Scholar 

  5. 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.

    Article  CAS  PubMed  Google Scholar 

  6. 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.

    Article  PubMed  Google Scholar 

  7. Sheth S, Branstetter BF, IV, Escott EJ. Appearance of normal cranial nerves on steady-state free precession MR images. Radiographics. 2009;29:1045–55.

    Article  PubMed  Google Scholar 

  8. 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.

    Article  PubMed  Google Scholar 

  9. 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.

    Article  CAS  PubMed  Google Scholar 

  10. 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.

    Article  CAS  PubMed  Google Scholar 

  11. 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.

    Article  CAS  PubMed  Google Scholar 

  12. 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  Google Scholar 

  13. 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  Google Scholar 

  14. 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.

    Article  PubMed  Google Scholar 

  15. 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.

    Article  PubMed  Google Scholar 

  16. 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.

    Article  PubMed  Google Scholar 

  17. 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  Google Scholar 

  18. 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.

    Article  Google Scholar 

  19. 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.

    Article  PubMed  Google Scholar 

  20. Iaconetta G, Fusco M, Samii M. The sphenopetroclival venous gulf: a microanatomical study. J Neurosurg. 2003;99:366–75.

    Article  PubMed  Google Scholar 

  21. Kshettry VR, Lee JH, Ammirati M. The Dorello canal: historical development, contraversies in microsurgical anatomy, and clinical implications. Neurosurg Focus. 2013;34:E4.

    Article  PubMed  Google Scholar 

  22. 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.

    Article  PubMed  Google Scholar 

  23. 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.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to A. Özgür.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Özgür, A., Esen, K., Kara, E. et al. Visualization of the Abducens Nerve in its Petroclival Segment Using Contrast-Enhanced FIESTA MRI: The Size of the Petroclival Venous Confluence Affects Detectability. Clin Neuroradiol 27, 97–103 (2017). https://doi.org/10.1007/s00062-015-0415-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00062-015-0415-x

Keywords

Navigation