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Anatomie der Schädelbasis und Hirnnerven in der Schnittbildgebung

Anatomy of the skull base and the cranial nerves in slice imaging

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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.

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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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