Compressed print of the cranial nerves observed on Multislice Motion-Sensitized Driven-Equilibrium (MSDE) in patients with neurovascular compression. Department.

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Compressed print of the cranial nerves observed on Multislice Motion-Sensitized Driven-Equilibrium (MSDE) in patients with neurovascular compression. Department of Radiology, Faculty of Medicine, Yamagata University M. Kanoto M.D. *, A. Oda M.D., A. Oda M.D., T. Hosoya M.D.

Motion-Sensitized Driven-Equilibrium (MSDE) ・ A novel MRI technique similar to acquisition of DWI can obtain 3D data - with T1 contrast - without flow signal

Plaque imaging Brain metastasis - completely suppression of blood flow Motion-Sensitized Driven-Equilibrium (MSDE)

Vessel Nerve MRC Gd-T1FFEMSDE MSDE can render the neural compressed print!?

Purpose To observe the compressed neural print

MRI unit and MSDE parameter MRI Intera Achieva 3.0 T, Philips, Netherland TR / TE (ms)7.6 / 3.4 FOV (mm)200 b-factor10 Matrix256 × 256 Slices60 Slice thickness (mm)0.8 Flip angle (deg)20 CoilSENSE-Head-8ch Scan Time5’ 17”

- 5 with trigeminal neuralgia, 4 with hemifacial spasm - male : female = 1 : 8 - average, 69.4 years old - from November, 2008 to August, all with Gd-T1FFE, MRC and MSDE Materials 9 patients with neurovascular compression

Diagnosis of neurovascular compression by both Gd-T1FFE and MRC Image (MSDE) analysis 1. compressed print of the nerves - existence and portion 2. comparing operation findings 3. follow up clinical examinations and MRI Methods

TN; trigeminal neuralgia HFS; hemifacial spasm SCA; superior cerebellar artery BA; basilar artery AICA; anterior inferior cerebellar artery PICA; posterior inferior cerebellar artery Results Case No. CaseSymptom Culprit Vessels Rendering Neural Compressed Print (NCP) by MSDE NCP in operative findings Improvement of NCP by MSDE Symptom postoperation 180 y.o. FLt. TNSCA +++ Disappeared 272 y.o. FRt. HFSAICA +++ Disappeared 372 y.o.MLt. HFSPICA +++ Disappeared 468 y.o. FRt. TNAICA −−− Disappeared 578 y.o. FRt. TNAICA, vein +++ Disappeared 667 y.o. FRt. HFSAICA −−− Disappeared 766 y.o. FLt. TNSCA +++ Disappeared 872 y.o. FLt. TNBA, AICA +−+ Disappeared 950 y.o. FLt. HFSPICA −−− Disappeared

・ Neural compressed prints were observed in 6 of 9 patients by preoperative MSDE study. ・ MSDE findings were well consistent with operative findings except only one case (case 8). ・ All neural compressed prints were disappeared in the first post-operative MSDE studies which were performed within from 4 to 12 days (average; 7 days). ・ All neurological symptoms were improved at latest within 7days (average; 1.8 days). Results Case No. CaseSymptom Culprit Vessels Rendering Neural Compressed Print (NCP) by MSDE NCP in operative findings Improvement of NCP by MSDE Symptom postoperation 180 y.o. FLt. TNSCA +++ Disappeared 272 y.o. FRt. HFSAICA +++ Disappeared 372 y.o.MLt. HFSPICA +++ Disappeared 468 y.o. FRt. TNAICA −−− Disappeared 578 y.o. FRt. TNAICA, vein +++ Disappeared 667 y.o. FRt. HFSAICA −−− Disappeared 766 y.o. FLt. TNSCA +++ Disappeared 872 y.o. FLt. TNBA, AICA +−+ Disappeared 950 y.o. FLt. HFSPICA −−− Disappeared

MRC Gd-T1FFE MSDE Lt. trigeminal neuralgia: 80 Y female (Case 1)

Lt. hemifacial spasm: 72 Y male (case 3) MRC Gd-T1FFE MSDE

Lt. hemifacial spasm: 72 Y male (case 3)

Pre Ope. Post Ope. Lt. hemifacial spasm: 72 Y male (case 3)

Rt. hemifacial spasm 67 Y female (case 6) Ⅶ Ⅷ Vessel Ⅶ Ⅷ Ⅶ MRC Gd-T1FFE MSDE Ⅷ

AICA touched the root exit zone of facial nerve. However, the neural compressed print was not observed. Rt. hemifacial spasm 67 Y female (case 6)

・ We can demonstrate the neural compressed print of the cranial nerves in patients with NVC using MSDE, findings of which were well consistent with the operative findings. ・ The neural compressed prints were promptly disappeared just after operation. Conclusion