颅神经影像检查.ppt

右舌下神经麻痹，舌肌萎缩 MRI对颅神经的显示价值 常规MRI的限度 MRH 常用序列：FIESTA；CISS 优势 清楚显示神经及血管神经关系 测量 适于显示的颅神经： Ⅲ、 Ⅳ、 Ⅴ、Ⅵ、Ⅶ、Ⅷ、Ⅸ、Ⅹ、Ⅺ、Ⅻ 3-12 嗅球 CN I 视神经、视交叉、视束 CN II 动眼神经：中脑脚间窝出脑 CN III 艾滋病合并颅神经淋巴瘤 动脉瘤压迫 滑车神经 滑车神经：中脑背侧下丘下方与上髓帆出脑，绕过大脑脚外侧前行（背侧唯一神经） CN IV 滑车神经纤维瘤 A B 脑实质淋巴瘤和淋巴瘤性脑膜炎 A B 三叉神经: 脑桥基底部与小脑中脚交界处出脑，感觉根粗大，运动根细小 CN V MRH轴位 三叉神经起始、走行 以及PEZ、PGS、 REZ A B C 椎动脉压迫三叉神经 神经纤维瘤病1型，左三叉神经丛状神经纤维瘤 A B C D 延髓脑桥沟由前到后分别为展神经、面神经、前庭蜗神经（展面前） CN VI、VII、VIII 常规MRI MRH 扭曲的基底动脉压迫左侧面神经 A B 右侧面神经和膝状神经节炎 A B 听神经鞘瘤 * Figure 52-5 Parenchymal lymphoma and lymphomatous meningitis in an immunocompromised patient without AIDS. A, Enhanced image at the level of the cerebral peduncles. There are enhancement of the midbrain and enhancement of the left trochlear nerve (arrowhead). B, Axial enhanced scan at the level of the midpons. A similar nodular focus of enhancement is seen in the left CPA (arrowhead). * Figure 52-7 Vascular compression of the left fifth nerve in a 69-year-old man with tic douloureux. A, Axial image showing outward displacement and compression of the left trigeminal nerve at its root entry zone (arrowhead). B, Coronal view showing tortuous vascular structure that compresses the cisternal portion of the left trigeminal nerve (arrowhead). Note that the vessel crosses the midline inferiorly, suggesting it may be the basilar artery. C, 3D time-of-flight MR angiogram demonstrates that the compressive lesion is the markedly dominant right vertebral artery, which extends cephalad into the left CPA cistern (open arrowhead). * Figure 52-6 Plexiform neurofibroma of the left fifth nerve in a patient with neurofibromatosis type 1. A and B, Coronal enhanced scans. Note that the tumor involves the left foramen rotundum (arrowhead in A) and extends through the left foramen ovale into the cavernous sinus (arrowhead in B). C and D, Enhanced axial images. Again, the course of the tumor is well seen. There is extension from the foramen rotundum into the region of Meckels cave on the left side (arrow in C)