J Neurol Surg B Skull Base 2019; 80(06): 648-654
DOI: 10.1055/s-0039-1677864
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Super-resolution Diffusion Tensor Imaging for Delineating the Facial Nerve in Patients with Vestibular Schwannoma

Lorenz Epprecht
1  Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2  Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
,
Elliott D. Kozin
1  Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2  Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
,
Marco Piccirelli
3  Department of Neuroradiology, University Hospital of Zurich, Zurich, Switzerland
4  Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
,
Vivek V. Kanumuri
1  Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2  Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
,
Osama Tarabichi
1  Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2  Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
,
Aaron Remenschneider
1  Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
5  Department of Otolaryngology, University of Massachusetts Medical School, Boston, Massachusetts, United States
,
Frederick G. Barker II
6  Department of Neurosurgery, Massachusetts General Hospital, Boston Massachusetts, United States
,
Michael J. McKenna
1  Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2  Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
,
Alexander M. Huber
7  Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland
,
Marybeth E. Cunnane
8  Department of Radiology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, United States
,
Katherine L. Reinshagen*
8  Department of Radiology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts, United States
,
Daniel J. Lee*
1  Eaton Peabody Laboratories, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, United States
2  Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, United States
› Author Affiliations
Funding Sources American Hearing Health Foundation.
Further Information

Publication History

16 October 2018

16 December 2018

Publication Date:
01 March 2019 (online)

Abstract

Objectives Predicting the course of cranial nerves (CNs) VII and VIII in the cerebellopontine angle on preoperative imaging for vestibular schwannoma (VS) may help guide surgical resection and reduce complications. Diffusion magnetic resonance imaging dMRI is commonly used for this purpose, but is limited by its resolution. We investigate the use of super-resolution reconstruction (SRR), where several different dMRIs are combined into one dataset. We hypothesize that SRR improves the visualization of the CN VII and VIII.

Design Retrospective case review.

Setting Tertiary referral center. SRR was performed on the basis of axial and parasagittal single-shot epiplanar diffusion tensor imaging on a 3.0-tesla MRI scanner.

Participants Seventeen adult patients with suspected neoplasms of the lateral skull base.

Main Outcome Measures We assessed separability of the two distinct nerves on fractional anisotropy (FA) maps, the tractography of the nerves through the cerebrospinal fluid (CSF), and FA in the CSF as a measure of noise.

Results SRR increases separability of the CN VII and VIII (16/17 vs. 0/17, p = 0.008). Mean FA of CSF surrounding the nerves is significantly lower in SRRs (0.07 ± 0.02 vs. 0.13 ± 0.03 [axial images]/0.14 ± 0.05 [parasagittal images], p = 0.00003/p = 0.00005). Combined scanning times (parasagittal and axial) used for SRR were shorter (8 minute 25 seconds) than a comparable high-resolution scan (15 minute 17 seconds).

Conclusion SRR improves the resolution of CN VII and VIII. The technique can be readily applied in the clinical setting, improving surgical counseling and planning in patients with VS.

Financial Disclosures

None.


* Contributed equally.