MRI of the inferior alveolar nerve and lingual nerve—anatomical variation and morphometric benchmark values of nerve diameters in healthy subjects
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Since MRI using dedicated imaging sequences has recently shown promising results in direct visualization of the inferior alveolar nerve (IAN) and the lingual nerve (LN) with high spatial resolution, the aim of this study was to generate suitable standard specifications to reliably depict the IAN and LN in MRI and to delineate the anatomy and its variants of these nerves in healthy subjects.
Thirty healthy volunteers were examined on a 3-T scanner (Elition, Philips Healthcare, Best, the Netherlands). The sequence protocol consisted of 3D STIR, 3D DESS, and 3D T1 FFE “black bone” sequences.
The study reconfirmed a good feasibility of direct visualization of proximal and peripheral portions of the IAN and of the proximal course of the LN. The STIR sequence showed the highest apparent signal to noise ratio (aSNR) and best apparent nerve-muscle contrast to noise ratio (aNMCNR) for IAN and for the LN. The applied MRI sequences allowed to differentiate the tissue composition of the neurovascular bundle inside the mandibular canal.
Dedicated MRI sequence protocols proved effectively to detect the IAN and LN and their course in healthy volunteers. The tissue composition of the mandibular neurovascular bundle was conclusively distinguishable as was the varying topography inside multiple bony channels.
The presented data on the precise and valid visualization of the IAN and LN have clinical implications in respect to local anesthesia prior to dental treatments in the mandible but also regarding surgical procedures and implant insertion in the molar region.
KeywordsMRI Inferior alveolar nerve Lingual nerve Imaging Preoperative diagnostics
Apparent nerve-muscle contrast to noise ratio
Apparent signal to noise ratio
Cone beam computed tomography
Contrast to noise ratio
Double-echo steady state
Inferior alveolar nerve
Magnetic resonance imaging
Region of interest
Short tau inversion recovery
Egon Burian: data segmentation, drafting of manuscript, concept of study design, data acquisition, data post-processing.
Florian A. Probst: critical revision of manuscript.
Dominik Weidlich: critical revision of manuscript.
Carl-Peter Cornelius: critical revision of manuscript.
Lisa Meier: data acquisition, critical revision of manuscript.
Teresa Robl: data acquisition, critical revision of manuscript.
Claus Zimmer: critical revision of manuscript.
Dimitrios C. Karampinos: critical revision of manuscript.
Lucas Ritschl: critical revision of manuscript.
Monika M. Probst: concept of study design, data acquisition, data post-processing, statistical analysis, critical revision of manuscript.
Compliance with ethical standards
Conflict of Interest
The authors declare that they have no conflict of interest.
The institutional ethics committee approved the study design.
Informed consent was obtained from all individual participants included in the study.
- 11.Albuquerque AFM, Soares ECS, de Barros Silva PG, de Lima BB, Carvalho FSR, Ribeiro TR, de Sa CD, Costa FWG (2019) Clinical investigation of gustatory and neurosensory alterations following mandibular third molar surgery: an observational prospective study. Clin Oral Investig 23:2941–2949. https://doi.org/10.1007/s00784-018-02798-5 CrossRefPubMedGoogle Scholar
- 15.Probst M, Richter V, Weitz J, Kirschke JS, Ganter C, Troeltzsch M, Nittka M, Cornelius CP, Zimmer C, Probst FA (2017) Magnetic resonance imaging of the inferior alveolar nerve with special regard to metal artifact reduction. J Craniomaxillofac Surg 45:558–569. https://doi.org/10.1016/j.jcms.2017.01.009 CrossRefPubMedGoogle Scholar
- 16.Klupp E, Cervantes B, Sollmann N, Treibel F, Weidlich D, Baum T, Rummeny EJ, Zimmer C, Kirschke JS, Karampinos DC (2018) Improved brachial plexus visualization using an adiabatic iMSDE-prepared STIR 3D TSE. Clin Neuroradiol:1–8. https://doi.org/10.1007/s00062-018-0706-0
- 19.Assaf AT, Zrnc TA, Remus CC, Schonfeld M, Habermann CR, Riecke B, Friedrich RE, Fiehler J, Heiland M, Sedlacik J (2014) Evaluation of four different optimized magnetic-resonance-imaging sequences for visualization of dental and maxillo-mandibular structures at 3 T. J Craniomaxillofac Surg 42:1356–1363. https://doi.org/10.1016/j.jcms.2014.03.026 CrossRefPubMedGoogle Scholar