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Trigeminal Nerve(CN V) MRI

Indications for Trigeminal nerve MRI scan

Trigeminal nerve anatomy

The trigeminal nerve is one of the 12 cranial nerves and is responsible for transmitting sensory information from the face to the brain. It is the largest cranial nerve and has both sensory and motor functions. The trigeminal nerve is divided into three main branches: the ophthalmic nerve (V1), the maxillary nerve (V2), and the mandibular nerve (V3). Let’s explore each branch in more detail:

Ophthalmic Nerve (V1):

The ophthalmic nerve is the smallest branch and provides sensory innervation to the upper part of the face, including the forehead, scalp, upper eyelid, and the front part of the scalp.
It also carries sensory information from the cornea, conjunctiva, and the nasal cavity.

Maxillary Nerve (V2):

The maxillary nerve supplies sensory innervation to the middle part of the face, including the lower eyelid, upper lip, cheek, and part of the nasal cavity.
It also provides sensory input from the maxillary teeth, palate, sinuses, and the meninges of the middle cranial fossa.

Mandibular Nerve (V3):

The mandibular nerve is the largest branch of the trigeminal nerve and has both sensory and motor functions.
Sensory innervation includes the lower lip, chin, lower teeth, part of the cheek, and the anterior two-thirds of the tongue.
Motor fibers of the mandibular nerve control the muscles involved in chewing (mastication).

Trigeminal neuralgia

Trigeminal neuralgia is a debilitating condition characterized by severe facial pain originating from the trigeminal nerve. The intense, electric shock-like pain episodes can significantly impact a person’s daily life, causing difficulty with eating, speaking, and even simple facial movements. MRI plays a crucial role in the diagnosis of trigeminal neuralgia as it helps identify the underlying causes. It can detect potential compressions of the trigeminal nerve by nearby blood vessels, tumors, or structural abnormalities. MRI can provide detailed images of the nerve, aiding in treatment planning and determining the most appropriate management options, including medication or surgical interventions.

Trigeminal nerve anatomy pitcher

Contraindications

Patient preparation for Trigeminal nerve MRI

Positioning for Trigeminal nerve MRI

mri brain planning and positioning

Recommended Trigeminal Nerve MRI Protocols and Planning

Trigeminal nerve MRI localiser

To plan the sequences, it is necessary to acquire a three-plane localizer, which typically consists of T1 weighted low-resolution scans lasting less than 25 seconds.

trigeminal nerve(CN V) mri MRI localiser image

T2 STIR coronal 3mm SFOV

Plan the coronal slices on the sagittal plane; angle the positioning block perpendicular to the hard palate. Check the positioning block in the other two planes. Provide an appropriate angle in the axial plane (perpendicular to the nasal septum). The slices must be sufficient to cover the entire face from the nose to the level of the fourth ventricle.

MRI trigeminal nerve Planning of coronal scans

Parameters

TR

5000-6000

TE

110

FLIP

130

NEX

3

SLICE

3 MM

MATRIX

256X256

FOV

160-180

PHASE

R>L

GAP

10%

TI

150

T1 tse coronal 3mm small FOV

Plan the coronal slices on the sagittal plane; angle the positioning block perpendicular to the hard palate. Check the positioning block in the other two planes. Provide an appropriate angle in the axial plane (perpendicular to the nasal septum). The slices must be sufficient to cover the entire face from the nose to the level of the fourth ventricle.

MRI trigeminal nerve Planning of coronal scans

Parameters

TR

400-600

TE

15-25

SLICE

3 MM

FLIP

140

PHASE

R>L

MATRIX

256X256

FOV

160-180

GAP

10%

NEX(AVRAGE)

2

T2 3D SPACE or CISS coronal .9mm

Plan the coronal 3D block on the sagittal plane; angle the positioning block perpendicular to the hard palate. Check the positioning block in the other two planes. An appropriate angle must be given in the axial plane (perpendicular to the nasal septum). Slices must be sufficient to cover the trigeminal main branches from the frontal slice to the level of the fourth ventricle.

Parameters

TR

2000-2500

TE

250-300

SLICE

.9MM

FLIP

150

PHASE

R>L

MATRIX

320X320

FOV

160-200

GAP

10%

NEX(AVRAGE)

1.6

T2 tse axial 3mm SFOV

Plan the axial slices on the sagittal plane; angle the positioning block parallel to the hard palate. Check the positioning block in the other two planes. An appropriate angle must be given in the coronal plane (perpendicular to the nasal septum). Slices must be sufficient to cover the face from the glabella down to the angle of the jaw.

MRI trigeminal nerve Planning of axial scans

Parameters

TR

4000-5000

TE

100-120

SLICE

3 MM

FLIP

130-150

PHASE

R>L

MATRIX

288X256

FOV

160-170

GAP

10%

NEX(AVRAGE)

3

T2 tse sagittal 3mm SFOV

Plan the sagittal slices on the axial plane; angle the positioning block parallel to the nasal septum. Check the positioning block in the other two planes. An appropriate angle must be given in the coronal plane (parallel to the nasal septum). The slices should adequately cover the face from the right pinna to the left pinna.

MRI trigeminal nerve Planning of sagittal scans

Parameters

TR

4000-5000

TE

100-120

SLICE

3 MM

FLIP

130-150

PHASE

R>L

MATRIX

288X256

FOV

160-170

GAP

10%

NEX(AVRAGE)

3

For contrast enhanced scans

After administering the IV gadolinium DTPA injection, please continue with the following sequences. The document below grants access to the manufacturer's recommended dosage of gadolinium DTPA injection.

T1 VIBE DIXON axial .8mm SFOV ISO post contrast

Plan the axial 3D block on the sagittal plane and angle the positioning block parallel to the hard palate. Check the positioning block in the other two planes. An appropriate angle must be given in the coronal plane (perpendicular to the nasal septum). Slices should be sufficient to cover the face from the glabella down to the angle of the jaw.

Parameters

TR

7-8

TE

2.39 4.77

SLICE

.8 MM

FLIP

12-15

PHASE

R>L

MATRIX

224X224

FOV

200mm

GAP

10%

NEX(AVRAGE)

2

The post-contrast isotropic 3D scans can be reconstructed into coronal and sagittal planes, enabling the visualization of the anatomy in three dimensions.