Quantitative Analysis of the Facial Nerve Using Contrast-Enhanced Three Dimensional FLAIR-VISTA Imaging in Pediatric Bell’s Palsy
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Purpose: To evaluate the usefulness of quantitative analysis of the facial nerve usingcontrast-enhanced three-dimensional (CE 3D) fluid-attenuated inversion recoveryvolumeisotopic turbo spin echo acquisition (FLAIR-VISTA) for the diagnosis of Bell’spalsy in pediatric patients. Materials and Methods: Twelve patients (24 nerves) with unilateral acute facialnerve palsy underwent MRI from March 2014 through March 2015. The unaffectedsides were included as a control group. First, for quantitative analysis, the signalintensity (SI) and relative SI (RSI) for canalicular, labyrinthine, geniculate ganglion,tympanic, and mastoid segments of the facial nerve on CE 3D FLAIR images weremeasured using regions of interest (ROI). Second, CE 3D FLAIR and CE T1-SE imageswere analyzed to compare their diagnostic performance by visual assessment (VA). The sensitivity, specificity, and accuracy of RSI measurement and VA were compared. Results: The absolute SI of canalicular and mastoid segments and the sum of the fivemean SI (total SI) were higher in the palsy group than in the control group, but withno significant differences. The RSI of the canalicular segment and the total SI weresignificantly correlated with the symptomatic side (P = 0.028 and 0.015). In 11/12(91.6%) patients, the RSI of total SI resulted in accurate detection of the affectedside. The sensitivity, specificity, and accuracy for detecting Bell’s palsy were higherwith RSI measurement than with VA of CE 3D FLAIR images, while those with VA ofCE T1-SE images were higher than those with VA of CE 3D FLAIR images. Conclusion: Quantitative analysis of the facial nerve using CE 3D FLAIR imaging canbe useful for increasing the diagnostic performance in children with Bell’s palsy whendifficult to diagnose using VA alone. With regard to VA, the diagnostic performanceof CE T1-SE imaging is superior to that of CE 3D FLAIR imaging in children. Furtherstudies including larger populations are necessary.
Abstract
Purpose: To evaluate the usefulness of quantitative analysis of the facial nerve usingcontrast-enhanced three-dimensional (CE 3D) fluid-attenuated inversion recoveryvolumeisotopic turbo spin echo acquisition (FLAIR-VISTA) for the diagnosis of Bell’spalsy in pediatric patients. Materials and Methods: Twelve patients (24 nerves) with unilateral acute facialnerve palsy underwent MRI from March 2014 through March 2015. The unaffectedsides were included as a control group. First, for quantitative analysis, the signalintensity (SI) and relative SI (RSI) for canalicular, labyrinthine, geniculate ganglion,tympanic, and mastoid segments of the facial nerve on CE 3D FLAIR images weremeasured using regions of interest (ROI). Second, CE 3D FLAIR and CE T1-SE imageswere analyzed to compare their diagnostic performance by visual assessment (VA). The sensitivity, specificity, and accuracy of RSI measurement and VA were compared. Results: The absolute SI of canalicular and mastoid segments and the sum of the fivemean SI (total SI) were higher in the palsy group than in the control group, but withno significant differences. The RSI of the canalicular segment and the total SI weresignificantly correlated with the symptomatic side (P = 0.028 and 0.015). In 11/12(91.6%) patients, the RSI of total SI resulted in accurate detection of the affectedside. The sensitivity, specificity, and accuracy for detecting Bell’s palsy were higherwith RSI measurement than with VA of CE 3D FLAIR images, while those with VA ofCE T1-SE images were higher than those with VA of CE 3D FLAIR images. Conclusion: Quantitative analysis of the facial nerve using CE 3D FLAIR imaging canbe useful for increasing the diagnostic performance in children with Bell’s palsy whendifficult to diagnose using VA alone. With regard to VA, the diagnostic performanceof CE T1-SE imaging is superior to that of CE 3D FLAIR imaging in children. Furtherstudies including larger populations are necessary.
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