MR Diagnosis of Facial Neuritis: Diagnostic Performance of Contrast-Enhanced 3D-FLAIR Technique Compared with Contrast-Enhanced 3D-T1-Fast-Field Echo with Fat Suppression

作者：Lim H K; Lee J H^*; Hyun D; Park J W; Kim J L; Lee H Y; Park S; Ahn J H; Baek J H; Choi C G

来源：American Journal of Neuroradiology, 2012, 33(4): 779-783.

DOI：10.3174/ajnr.A2851

BACKGROUND AND PURPOSE: Current MRI with the CE T1-weighted sequence plays a limited role in the evaluation of facial neuritis due to prominent normal facial nerve enhancement. Our purpose was to retrospectively investigate the usefulness of the CE 3D-FLAIR sequence compared with the CE 3D-T1-FFE sequence in facial neuritis patients. %26lt;br%26gt;MATERIALS AND METHODS: We assessed 36 consecutive patients who underwent temporal bone MR imaging at 31 for idiopathic facial palsy. Two readers independently reviewed CE 3D-T1-FFE and CE 3D-FLAIR images to determine the degree of enhancement in each of 5 segments of the facial nerve. We compared AUCs using the Z-test, compared diagnostic performance of 2 MR techniques with the McNemar test, and evaluated interobserver agreement. The Pearson chi(2) test was used for each segment of the facial nerve. %26lt;br%26gt;RESULTS: The AUC of CE 3D-FLAIR (reader 1, 0.754; reader 2, 0.7461 was greater than that of CE 3D-T1-FFE (reader 1, 0.624; reader 2, 0.640; P %26lt; .001). The diagnostic sensitivities, specificities, and accuracies were 97.2%, 86.1%, and 91.7%, respectively, for CE 3D-FLAIR, and 100%, 56.9%, and 78.5%, respectively, for CE 3D-T1-FFE. The specificity and accuracy of CE 3D-FLAIR were greater than those of CE 3D-T1-FFE (specificity, P = .029; accuracy, P = .008). The interobserver agreements for CE 3D-FLAIR (kappa-value, 0.831) and CE 3D-T1-FFE (kappa-value, 0.694) were excellent. Enhancement of the canalicular and anterior genu segments on CE 3D-FLAIR were significantly correlated with the occurrence of facial neuritis (P %26lt; .001 for canalicular; P = .032 and 0.020 for anterior genu by reader 1 and reader 2, respectively). %26lt;br%26gt;CONCLUSIONS: CE 3D-FLAIR can improve the specificity and overall accuracy of MR imaging in patients with idiopathic facial palsy.

• 出版日期2012-4