Utility of Contrast-enhanced 3D T1-weighted CUBE Fat Sat Sequence MRI to Evaluate Pathological Cranial Nerve EnhancementA Prospective Longitudinal Study

Introduction: Abnormal Cranial Nerve (CN) enhancement can point towards an underlying disorder or disease severity. Therefore, the depiction of this feature is of utmost importance in the evaluation of various pathologies. Various Magnetic Resonance Imaging (MRI) sequences have a role in the early identification of such findings.

Aim: To study the spectrum of cases of abnormal CN enhancement on MRI and the role of contrast-enhanced 3 Dimensional (3D) T1-weighted CUBE Fat saturated sequence in evaluating pathological CN enhancement.

Materials and Methods: This cross-sectional study was conducted in the Department of Radiodiagnosis at Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India. The duration of the study was 2 years, from June 2020 to June 2022. Study included 50 patients who presented with signs and symptoms of CN involvement or were referred for other pathologies with incidental detection of pathological nerve enhancement on 1.5 Tesla (T) MRI Scanner. The data was transferred to a Microsoft Excel 2010 sheet and results were expressed in terms of frequency and percentages.

Results: The mean age of the study participants was 33.3±20.9 years. Male to female ratio was 28:22=1.27:1. Infections were the most common cause of abnormal CN enhancement 26 (52%) cases followed by demyelination 3 (6%) cases, haematological malignancy 4 (8%) cases, metastatic neural infiltration 5 (20%), primary neural tumours 4 (18%), Bell’s palsy 1 (2%) case, Tolosa Hunt Syndrome (THS) 1 (2%) case and idiopathic polyneuritis cranialis 1 (2%) case.

Conclusion: Contrast-enhanced 3D T1 CUBE Fat-saturation (FS) sequence is excellent in depicting abnormal CN enhancement, especially the cisternal segments.