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AJNR - American Journal of Neuroradiology

Published ahead of print on March 25, 2009
doi: 10.3174/ajnr.A1525

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Detailed MR Imaging Anatomy of the Cisternal Segments of the Glossopharyngeal, Vagus, and Spinal Accessory Nerves in the Posterior Fossa: The Use of 3D Balanced Fast-Field Echo MR Imaging

W.-J. Moon^a, H.G. Roh^a and E.C. Chung^b

^a Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Korea
^b Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

View larger version (58K): [in this window] [in a new window]   Fig 1. A diagrammatic representation of the posterior view of the left internal acoustic meatus and the JF after removal of the cerebellum. The short arrow indicates the opening of the cochlear aqueduct. The long arrow indicates the dural ring, which divides the endocranial openining of the JF: the recess for CN IX and the recess for CN X/XI. T indicates tentorium cerebelli; SCP, superior cerebellar peduncle; MCP, middle cerebellar peduncle; MO, medulla oblongata; VA, vertebral artery; IV, trochlear nerve; VII, facial nerve; VIII, vestibulocochlear nerve; IX, glossopharyngeal nerve; X, vagus nerve; XI, spinal accessory nerve; XII, hypoglossal nerve.

View larger version (83K): [in this window] [in a new window]   Fig 2. Axial 3D-bFFE images at the level of each compartment of the JF on the left side. The angle between each compartment and the posterior petrosal surface was visualized by a line drawing. A–C, The dotted arrow indicates CN IX (A and B) and the black arrow indicates the CN X/XI complex (C). Note that the angle of the cochlear aqueduct (A) is the smallest, whereas the angle of the recess for the CN X/XI complex (C) is the largest. The angle of the recess for CN IX (B) is between the angles of the cochlear aqueduct and the recess for the CN X/XI complex.

View larger version (104K): [in this window] [in a new window]   Fig 3. Axial 3D-bFFE images of the lower cranial nerves from the level of the cochlear aqueduct to the level of the lower margin of the JF on the left side. A and B, The white arrows indicate the recess for the cochlear aqueduct. C–E, Just below the level of the cochlear aqueduct, the glossopharyngeal nerve (small black arrows in C–E) is visualized in the recess for the glossopharyngeal nerve (white dotted arrow in C and D). Just inferior to the glossopharyngeal nerve, there is a dural ring seen as slightly dark signal intensity at the apex of the JF (white crossed arrow in E). F and G, Just below the level of the dural ring, the recess for the CN X/XI complex (white arrowhead) and the vagus nerve (black arrowhead) is visualized. H, The spinal accessory nerve (black arrow) is visualized in the recess for the CN X/XI complex (white arrowhead) at the level of the lower end of the JF.

View larger version (131K): [in this window] [in a new window]   Fig 4. Oblique sagittal reformatted 3D-bFFE image at the level of the JF. The short arrow indicates the glossopharyngeal nerve within the recess for CN IX, and the long arrow indicates the vagus/spinal accessory nerve complex within the recess for the CN X/XI complex. JV indicates jugular vein.