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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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Abstract

Objective

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.

Methods

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.

Results

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.

Conclusion

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.

Clinical relevance

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.

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Abbreviations

aNMCNR:

Apparent nerve-muscle contrast to noise ratio

aSNR:

Apparent signal to noise ratio

CBCT:

Cone beam computed tomography

CI:

Confidence interval

CT:

Computed tomography

CNR:

Contrast to noise ratio

DESS:

Double-echo steady state

IAN:

Inferior alveolar nerve

LN:

Lingual nerve

MRI:

Magnetic resonance imaging

ROI:

Region of interest

SD:

Standard deviation

SI:

Signal intensity

STIR:

Short tau inversion recovery

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81765, Munich, Germany

    Egon Burian, Lisa Maier, Teresa Robl, Claus Zimmer & Monika Probst

  2. Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, LMU Munich, Munich, Germany

    Florian A. Probst & Carl-Peter Cornelius

  3. Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Dominik Weidlich & Dimitrios C. Karampinos

  4. Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany

    Lucas M. Ritschl

Authors
  1. Egon Burian
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  2. Florian A. Probst
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  4. Carl-Peter Cornelius
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  5. Lisa Maier
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  6. Teresa Robl
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  7. Claus Zimmer
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  8. Dimitrios C. Karampinos
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  9. Lucas M. Ritschl
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  10. Monika Probst
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Contributions

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.

Corresponding author

Correspondence to Egon Burian.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical approval

The institutional ethics committee approved the study design.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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This study was conducted at the Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Medical School Munich, Germany

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Burian, E., Probst, F.A., Weidlich, D. et al. MRI of the inferior alveolar nerve and lingual nerve—anatomical variation and morphometric benchmark values of nerve diameters in healthy subjects. Clin Oral Invest 24, 2625–2634 (2020). https://doi.org/10.1007/s00784-019-03120-7

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  • DOI: https://doi.org/10.1007/s00784-019-03120-7

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