PT - JOURNAL ARTICLE AU - S Sartoretti-Schefer AU - S Kollias AU - W Wichmann AU - A Valavanis TI - T2-weighted three-dimensional fast spin-echo MR in inflammatory peripheral facial nerve palsy. DP - 1998 Mar 01 TA - American Journal of Neuroradiology PG - 491--495 VI - 19 IP - 3 4099 - http://www.ajnr.org/content/19/3/491.short 4100 - http://www.ajnr.org/content/19/3/491.full SO - Am. J. Neuroradiol.1998 Mar 01; 19 AB - PURPOSE Our objective was to identify histologically and intraoperatively verified focal nerve thickening of the distal intrameatal segment on three-dimensional fast spin-echo (FSE) T2-weighted MR images as a new diagnostic criterion in patients with inflammatory peripheral facial nerve palsy.METHODS Twenty-two patients with clinically diagnosed unilateral (n = 20) or bilateral (n = 2) inflammatory peripheral facial nerve palsy were examined on a 1.5-T MR imager using noncontrast and contrast-enhanced T1-weighted SE sequences and 3-D T2-weighted FSE sequences with secondary reformations. Abnormal contrast enhancement and possible focal nerve thickening of the distal intrameatal segment, labyrinthine nerve segment, and geniculate ganglion region were analyzed prospectively.RESULTS In all patients, the T1-weighted postcontrast SE images showed characteristic smooth, linear, abnormally intense contrast enhancement of the distal intrameatal segment, indicating peripheral inflammatory nerve palsy. In 23 nerves (96%) a focal bulbous nerve thickening of the distal intrameatal segment was observed on 3-D T2-weighted FSE images. In 100% of patients with peripheral inflammatory facial nerve palsy, postcontrast T1-weighted SE images showed a smooth, linear, and abnormally intense contrast enhancement of the distal intrameatal segment; reformatted very thin 3-D T2-weighted FSE images showed a focal bulbous nerve thickening of the distal intrameatal segment in 96% of patients. These findings corresponded to intraoperative and histologic findings.CONCLUSION Three-dimensional T2-weighted FSE sequences are fast and cheap compared with T1-weighted postcontrast images, but secondary reformations are time-consuming and require exact anatomic knowledge for careful analysis of the different nerve segments.