Zusammenfassung
Zur Untersuchung der Schädelbasis sind sowohl die Computertomographie (CT) als auch Magnetresonanztomographie (MRT) geeignet. Während mittels CT vorzugsweise die exakte knöcherne Ausbreitung von Pathologien z. B. zur operativen Therapieplanung erfasst werden, dient die MRT sowohl der Darstellung von Pathologien bzgl. ihrer Ausbreitung im Weichteilgewebe als auch dem Nachweis knöcherner Infiltration.
Bei der Untersuchung der Schädelbasis wird eine hochauflösende Darstellung mit geringer Schichtdicke für beide Modalitäten angestrebt. Die genaue Kenntnis der Anatomie ist bereits bei der Untersuchungsplanung notwendig. Sie ist zudem Voraussetzung für das Erkennen und die korrekte Interpretation von Pathologien. Die MRT ist die bildgebende Methode der Wahl zur Abklärung von Pathologien der Hirnnerven. Dabei ist es durch gezielte Sequenzauswahl, die sich nach den die Hirnnerven umgebenen Strukturen richtet, möglich, den gesamten Verlauf der Hirnnerven zu beurteilen. Dieser Artikel beschreibt die Untersuchung der Schädelbasis mit der CT und MRT, geht ausführlich auf die Anatomie ein und illustriert diese anhand von Bildbeispielen.
Abstract
Computed tomography (CT) and magnetic resonance imaging (MRI) are suitable methods for examination of the skull base. Whereas CT is used to evaluate mainly bone destruction e.g. for planning surgical therapy, MRI is used to show pathologies in the soft tissue and bone invasion. High resolution and thin slice thickness are indispensible for both modalities of skull base imaging. Detailed anatomical knowledge is necessary even for correct planning of the examination procedures. This knowledge is a requirement to be able to recognize and interpret pathologies. MRI is the method of choice for examining the cranial nerves. The total path of a cranial nerve can be visualized by choosing different sequences taking into account the tissue surrounding this cranial nerve. This article summarizes examination methods of the skull base in CT and MRI, gives a detailed description of the anatomy and illustrates it with image examples.
Literatur
Casselman JW, Kuhweide R, Deimling M et al (1993) Constructive interference in steady state-3DFT MR imaging of the inner ear and cerebellopontine angle. AJNR Am J Neuroradiol 14:47–57
Casselman JW (2005) The skull base: tumoral lesions. Eur Radiol 15:534–542
Casselman JW, Mermuys K, Delanote J et al (2008) MRI of the cranial nerves-more than meets the eye: technical considerations and advanced anatomy. Neuroimaging Clin North Am 18:197–231
Ciftci E, Anik Y, Arslan A et al (2004) Driven equilibrium (drive) MR imaging of the cranial nerves V-VIII: comparison with the T2-weighted 3D TSE sequence. Eur J Radiol 5:234–240
Destrieux C, Velut S, Kakou MK et al (1997) A new concept in Dorello’s canal microanatomy: the petroclival venous confluence. J Neurosurg 87:67–72
Downs DM, Damiano TR, Rubinstein D (1996) Gasserian ganglion: appearance on contrast-enhanced MR. AJNR Am J Neuroradiol 17:237–241
Duvernoy HM (1995) Structure and functions of the brain stem. In: Duvernoy HM (ed) The human brain stem and cerebellum. Springer, Berlin Heidelberg New York, pp 41–89
Graziadei PPC, Monti Graziadei GA (1978) Continuous nerve cell renewal in the olfactory system. In: Jacobson M (ed) Handbook of sensory physiology. Vol 9, development of sensory systems. Springer, Berlin Heidelberg New York, pp 55–83
Jung NY, Moon WJ, Lee MH et al (2007) Magnetic resonance cisternography: comparison between 3-dimensional driven equilibrium with sensitivity encoding and 3-dimensional balanced fast-field echo sequences with sensitivity encoding. J Comput Assist Tomogr 31:588–591
Laine FJ, Nadel L, Braun IF (1990) CT and MR imaging of the central skull base. Part 1: Techniques, embryologic development and anatomy. Radiographics 10:591–602
Lane JI, Ward H, Witte RJ et al (2004) 3-T imaging of the cochlear nerve and labyrinth in cochlear-implant candidates: 3D fast recovery fast spin-echo versus 3D constructive interference in the steady state techniques. AJNR Am J Neuroradiol 25:618–622
Linn J, Peters F, Moriggl B et al (2009) The jugular foramen: imaging strategy and detailed anatomy at 3T. AJNR Am J Neuroradiol 30:34–41
Linn J, Moriggl B, Schwarz F et al (2009) Cisternal segments of the glossopharyngeal, vagus and accessory nerves: detailed magnetic resonance imaging-demonstrated anatomy and neurovascular relationships. J Neurosurg [Epub ahead of print]
Okumura Y, Suzuki M, Takemura A et al (2005) Visualization of the lower cranial nerves by 3D-FIESTA. Nippon Hoshasen Gijutsu Gakkai Zasshi 61(2):291–297
Rhoton AL Jr (2000) Jugular foramen. Neurosurgery 47 [suppl 3]:267–285
Rusu MC, Pop F, Curcă GC et al (2008) The pterygopalatine ganglion in humans: a morphological study. Ann Anat [Epub ahead of print]
Seitz J, Held P, Fründ R et al (2001) Visualization of the IXth to XIIth cranial nerves using 3-dimensional constructive interference in steady state, 3-dimensional magnetization-prepared rapid gradient echo and T2-weighted 2-dimensional turbo spin echo magnetic resonance imaging sequences. J Neuroimaging 11:160–164
Song MH, Lee HY, Jeon JS et al (2008) Jugular foramen schwannoma: analysis on its origin and location. Otol Neurotol 29:387–391
Tekdemir I, Tuccar E, Aslan A et al (2001) Comprehensive microsurgical anatomy of the jugular foramen and review of terminology. J Clin Neurosci 8:351–356
Tsuchiya K, Aoki C, Hachiya J (2004) Evaluation of MR cisternography of the cerebellopontine angle using a balanced fast-field-echo sequence: preliminary findings. Eur Radiol 14:239–242
Umansky F, Elidan J, Valarezo A (1991) Dorello’s canal: a microanatomical study. J Neurosurg 75:294–298
Umansky F, Valarezo A, Elidan J (1992) The microsurgical anatomy of the abducens nerve in its intracranial course. Laryngoscope 102:1285–1292
Yousry I, Moriggl B, Dieterich M et al (2002) MR anatomy of the proximal cisternal segment of the trochlear nerve: neurovascular relationships and landmarks. Radiology 223:31–38
Yousry I, Moriggl B, Schmid UD et al (2002) Detailed anatomy of the intracranial segment of the hypoglossal nerve: neurovascular relationships and landmarks on magnetic resonance imaging sequences. J Neurosurg 96:1113–1122
Yousry I, Moriggl B, Holtmannspoetter M et al (2004) Detailed anatomy of the motor and sensory roots of the trigeminal nerve and their neurovascular relationships: a magnetic resonance imaging study. J Neurosurg 10:427–734
Yousry I, Moriggl B, Schmid UD et al (2005) Trigeminal ganglion and its divisions: detailed anatomic MR imaging with contrast-enhanced 3D constructive interference in the steady state sequences. AJNR Am J Neuroradiol 26:1128–1135
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Bink, A., Berkefeld, J. & Zanella, F. Anatomie der Schädelbasis und Hirnnerven in der Schnittbildgebung. Radiologe 49, 584–597 (2009). https://doi.org/10.1007/s00117-008-1800-0
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DOI: https://doi.org/10.1007/s00117-008-1800-0