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Assessment of traumatic mandibular nerve using MR neurography sequence: a preliminary study

Authors
 Hyunwoo Yang  ;  Nak-Hoon Son  ;  Dongwook Kim  ;  Jae-Hee Chun  ;  Jin Sung Kim  ;  Tae Kyung Oh  ;  Minwook Lee  ;  Hyung Jun Kim 
Citation
 BMC ORAL HEALTH, Vol.24(1) : 750, 2024-06 
Journal Title
BMC ORAL HEALTH
Issue Date
2024-06
MeSH
Adult ; Aged ; Diffusion Magnetic Resonance Imaging / methods ; Female ; Humans ; Imaging, Three-Dimensional / methods ; Magnetic Resonance Imaging* / methods ; Male ; Mandibular Nerve / diagnostic imaging ; Mandibular Nerve Injuries / diagnostic imaging ; Middle Aged ; Signal-To-Noise Ratio ; Trigeminal Nerve Injuries / diagnostic imaging ; Young Adult
Keywords
Dental implant ; Inferior alveolar nerve ; Linear model ; Lingual nerve ; MR neurography ; Mandibular nerve ; Signal intensity
Abstract
Background: Iatrogenic mandibular nerve damage resulting from oral surgeries and dental procedures is painful and a formidable challenge for patients and oral surgeons alike, mainly because the absence of objective and quantitative methods for diagnosing nerve damage renders treatment and compensation ambiguous while often leading to medico-legal disputes. The aim of this study was to examine discriminating factors of traumatic mandibular nerve within a specific magnetic resonance imaging (MRI) protocol and to suggest tangible diagnostic criteria for peripheral trigeminal nerve injury.

Methods: Twenty-six patients with ipsilateral mandibular nerve trauma underwent T2 Flex water, 3D short tau inversion recovery (STIR), and diffusion-weighted imaging (DWI) acquired by periodically rotating overlapping parallel lines with enhanced reconstruction (PROPELLER) pulse sequences; 26 injured nerves were thus compared with contra-lateral healthy nerves at anatomically corresponding sites. T2 Flex apparent signal to noise ratio (FSNR), T2 Flex apparent nerve-muscle contrast to noise ratio (FNMCNR) 3D STIR apparent signal to noise ratio (SSNR), 3D STIR apparent nerve-muscle contrast to noise ratio (SNMCNR), apparent diffusion coefficient (ADC) and area of cross-sectional nerve (Area) were evaluated.

Results: Mixed model analysis revealed FSNR and FNMCNR to be the dual discriminators for traumatized mandibular nerve (p < 0.05). Diagnostic performance of both parameters was also determined with area under the receiver operating characteristic curve (AUC for FSNR = 0.712; 95% confidence interval [CI]: 0.5660, 0.8571 / AUC for FNMCNR = 0.7056; 95% confidence interval [CI]: 1.011, 1.112).

Conclusions: An increase in FSNR and FNMCNR within our MRI sequence seems to be accurate indicators of the presence of traumatic nerve. This prospective study may serve as a foundation for sophisticated model diagnosing trigeminal nerve trauma within large patient cohorts.
Files in This Item:
T202404514.pdf Download
DOI
10.1186/s12903-024-04514-0
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Wook(김동욱) ORCID logo https://orcid.org/0000-0001-6167-6475
Kim, Jinsung(김진성) ORCID logo https://orcid.org/0000-0003-1415-6471
Kim, Hyung Jun(김형준) ORCID logo https://orcid.org/0000-0001-8247-4004
Lee, Minwook(이민욱) ORCID logo https://orcid.org/0000-0003-2822-0489
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/200232
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