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Imaging of facial neuritis using T2-weighted gradient-echo fast imaging employing steady-state acquisition after gadolinium injection

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Abstract

Background

MRI is the modality of choice for the imaging of facial neuritis. Previously, gadolinium-enhanced T1-weighted imaging of the petrous bone, then FLAIR sequences were thought to be most informative for acute facial neuritis imaging. The aim of this study is to evaluate the value of contrast-enhanced T2-weighted sequence for the diagnosis of acute facial neuritis and compare it to contrast-enhanced T1-weighted and FLAIR sequences.

Methods

We included 50 patients with an acute unilateral idiopathic peripheral facial neuritis. An MRI (3 T) with three sequences was performed (T1-weighted, T2-weighted and FLAIR), all acquired after intravenous contrast-media injection.

Results

The contrast-enhanced T2-weighted sequence appeared to be the most accurate one for the diagnosis of acute facial neuritis (Se 94%, Sp 100%, accuracy 98.2%, p < 0.001), with a pathological facial nerve strongly (grade 2–3) enhancing and a homogenous enhancement along the course of the entire facial nerve. Contrast-enhanced T1-weighted (Se 80%, Sp 100%, accuracy 94.1%) and FLAIR sequences (92%, Sp 88%, accuracy 90%, p < 0.001) showed lower accuracy. On T1-weighted sequence, a strong enhancement (blurred margins) of the canalicular segment was observed in 80% of the cases when it was never observed in normal nerves.

Conclusion

A strong (= iso to hyperintense to the petrous fat signal) and diffuse (all segments) enhancement of the facial nerve on T2-weighted steady-state free precession sequence is a sensitive and specific sign for the diagnosis of acute idiopathic facial neuritis, and appears superior to T1WI and FLAIR sequences.

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Abbreviations

SSFP:

Steady-state free precession

FIESTA-C:

Fast imaging employing steady-state acquisition with cycle phase

IAC:

Internal auditory canal

IV:

Intravenous

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Service de Radiologie 1, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, 67200, Strasbourg, France

    Magali Hector, Ahmad Alnadji, Francis Veillon, Maher Abu Eid & Aïna Venkatasamy

  2. Lab. Stress Response and Innovative Therapies, Inserm U1113, Strasbourg University, Strasbourg, France

    Aïna Venkatasamy

  3. Service ORL, Hôpitaux Universitaires de Strasbourg, Strasbourg, France

    Anne Charpiot & Christian Debry

Authors
  1. Magali Hector
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  2. Ahmad Alnadji
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  3. Francis Veillon
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  4. Maher Abu Eid
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  5. Anne Charpiot
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  6. Christian Debry
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  7. Aïna Venkatasamy
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Correspondence to Magali Hector.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Hector, M., Alnadji, A., Veillon, F. et al. Imaging of facial neuritis using T2-weighted gradient-echo fast imaging employing steady-state acquisition after gadolinium injection. Eur Arch Otorhinolaryngol 278, 2501–2509 (2021). https://doi.org/10.1007/s00405-020-06375-z

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  • DOI: https://doi.org/10.1007/s00405-020-06375-z

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