Schnittbildanatomie der Schädelbasis

Zusammenfassung

Die Schädelbasis trennt das extrakranielle vom intrakraniellen Kompartiment und beinhaltet eine Vielzahl an knöchernen und Weichteilstrukturen. Für die Beurteilung der Schädelbasis ist es unabdingbar, mit der komplexen Anatomie vertraut zu sein. Um die Anzahl der Differenzialdiagnosen möglichst gering zu halten, ist es wichtig, die Inhalte der einzelnen Abschnitte zu kennen. Aufgrund des technischen Fortschritts und, weil die Schädelbasis einer klinischen Untersuchung nicht zugänglich ist, spielt die Schnittbildgebung eine wichtige Rolle in der Diagnostik. Für die Bildgebung werden sowohl MRT als auch CT eingesetzt, wobei beide Verfahren nicht konkurrierend, sondern häufig komplementär zum Einsatz kommen.

Abstract

The skull base divides the extracranial from the intracranial compartment and contains a multiplicity of bony and soft tissue structures. For evaluating the skull base profound knowledge of the complex anatomy is mandatory. To limit the number of differential diagnosis it is important to be familiar with the contents of the different compartments. Due to the technical progress and the difficulty in assessing the skull base clinically imaging plays a significant role in diagnosis. For imaging both MRI and CT are used, which represent not competing but complementary methods.

Kernaussagen

• Die Anatomie der Schädelbasis ist komplex.

• Die Bildgebung spielt eine wichtige Rolle für die Diagnostik bei Schädelbasisprozessen.

• Für eine korrekte Befundung ist es wichtig, die durch die Schädelbasis verlaufenden Strukturen zu kennen.

• Sowohl die CT als auch die MRT liefern wichtige Informationen zur Diagnosefindung.

Keywords

Skull base - MRI - CT

• Literatur

• 1 Durden DD, Williams III DW. Radiology of skull base neoplasms. Otolaryngol Clin N Am 2001; 34: 1043-1064
• 2 Som PM, Curtin HD. Head and neck imaging, skull base. 4th. ed. St. Louis: Mosby Year Book; 2003: 261-373 , 783 – 863
• 3 Atlas SW. Magnetic resonance imaging of the brain and spine. 3rd. ed. Philadelphia: Lippincott Williams & Wilkins; 2002
• 4 Kösling S, Bootz F. Bildgebung HNO-Heilkunde. 2. Auflage Berlin Heidelberg: Springer Verlag; 2015: 1-262
• 5 Chavhan GB, Babyn PS, Jankharia BG et al. Steady-State MR Imaging Sequences: Physics, Classification, and Clinical Applications. Radiographics 2008; 28: 1147-1160
• 6 Kösling S, Neumann K, Brandt S. CT and MRI of intrinsic space-occupying lesions of the bony skull base. Radiologe 2009; 49: 598-607
• 7 Laine FJ, Nadel L, Braun IF. CT and MR imaging of the central skull base. Part 1: Techniques, embryologic development and anatomy. Radiographics 1990; 10: 591-602
• 8 Casselman JW. The skull base: tumoral lesions. Eur Radiol 2005; 15: 534-542
• 9 Borges A, Lufkin R, Huang A et al. Frequency selective fat suppression MR imaging: localized asymmetric failure of fat suppression mimicking orbital disease. J Neuro Ophthalmol 1997; 17: 12-17
• 10 Fishbein NJ, Kaplan MJ. Magnetic resonance imaging of the central skull base. Top Magn Reson Imaging 1999; 10: 325-346
• 11 Tomura N, Hirano H, Sashi R et al. Comparison of MR imaging and CT in discriminating tumour infiltration of cortex and bone marrow in the skull base. Comput Med Imaging Graph 1998; 22: 41-51
• 12 Curtin HD. Detection of perineural spread: fat is a friend. AJNR Am J Neuroradiol 1998; 19: 1385-1386
• 13 Tomura N, Hirano H, Kato K et al. Comparison of MR imaging with CT in depiction of tumour extension into the peterygopalatine fossa. Clin Radiol 1999; 54: 361-366
• 14 Williams LS. Advanced concepts in the imaging of perineural spread of tumour to the trigeminal nerve. Top Magn Reson Imaging 1999; 10: 376-383
• 15 Glenn LW. Innovations in neuroimaging of skull base pathology. Otolaryngol Clin North Am 2005; 38: 613-629
• 16 Chong FH, Khoo BK, Fan YF. Imaging of the nasopharynx and skull base. Magn Reson Imaging N Am 2002; 10: 547-571
• 17 Casselman JW, Kuhweide R, Deimling M et al. Constructive interference in steady state-3DFT MR imaging of the inner ear and cerebellopontine angle. AJNR Am J Neuroradiol 1993; 14: 47-57
• 18 Lane JI, Ward H, Witte RJ et al. 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 2004; 25: 618-622
• 19 Tsuchiya K, Aoki C, Hachiya J. Evaluation of MR cisternography of the cerebellopontine angle using a balanced fast-field-echo sequence: preliminary findings. Eur Radiol 2004; 14: 239-242
• 20 Ciftci E, Anik Y, Arslan A et al. Driven equilibrium (drive) MR imaging of the cranial nerves V-VIII: comparison with the T2-weighted 3D TSE sequence. Eur J Radiol 2004; 5: 234-240
• 21 Jung NY, Moon WJ, Lee MH et al. 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 2007; 31: 588-591
• 22 Chavhan GB, Babyn PS, Jankharia BG et al. Steady-State MR Imaging Sequences: Physics, Classification, and Clinical Applications. Radiographics 2008; 28: 1147-1160
• 23 Roser F, Ebner FH, Danz S et al. Three-dimensional constructive interference in steady-state magnetic resonance imaging in syringomyelia: Advantages over conventional imaging. J Neurosurg Spine 2008; 8: 429-435
• 24 Mikami T, Minamida Y, Yamaki T et al. Cranial nerve assessment in posterior fossa tumors with fast imaging employing steady-state acquisition (FIESTA). Neurosurg Rev 2005; 28: 261-266
• 25 Schmitz B, Hagen T, Reith W. Three-dimensional true FISP for high-resolution imaging of the whole brain. Eur Radiol 2003; 13: 1577-1582
• 26 Casselman J, Mermuys K, Delanote J et al. MRI of the cranial nerves – more than meets the eye: technical considerations and advanced anatomy. Neuroimaging Clin N Am 2008; 18: 197-231
• 27 Wilson-Pauwels L, Akesson EJ, Stewart PA. Cranial nerves: anatomy and clinical comments. Philadelphia, Pa: Decker; 1988
• 28 Linn J, Peters F, Moriggl B et al. The jugular foramen: imaging strategy and detailed anatomy at 3T. AJNR Am J Neuroradiol 2009; 30: 34-41