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. 2018 Oct;40(10):2228-2234.
doi: 10.1002/hed.25318. Epub 2018 Jun 26.

Visualization of nerve fibers around the carotid bifurcation with use of a 9.4 Tesla microscopic magnetic resonance diffusion tensor imaging with tractography

Shin Saito  1 , Hiroyuki Ozawa  1 , Masato Fujioka  1 , Keigo Hikishima  2 , Junichi Hata  3 , Sho Kurihara  4 , Hirotaka James Okano  5 , Kaoru Ogawa  1
Affiliations

Visualization of nerve fibers around the carotid bifurcation with use of a 9.4 Tesla microscopic magnetic resonance diffusion tensor imaging with tractography

Shin Saito et al. Head Neck. 2018 Oct.

Abstract

Background: Precise imaging of nerves have been challenging in the head and neck region, mainly due to low spatial resolution. Here, we investigated how nerves in the head and neck region could be visualized using an ultra-high magnetic field MR system.

Methods: We used formol-carbol-fixed human cadaveric necks and obtained MR diffusion tensor images (DTIs) using a 9.4 Tesla (T) ultra-high magnetic field MR system. Afterward, we prepared tissue sections and checked the anatomic relationships between the neurons and the carotid artery in order to confirm that the visualized fibers are indeed neuron fibers.

Results: We were able to identify nerves, including the vagus nerve, the hypoglossal nerve, and the spinal-accessory nerve. Hematoxylin-eosin stained histological sections confirmed neuron fibers in the same anatomic position.

Conclusion: This technique has the feasibility to be applied for a more accurate anatomic understanding, maybe even close to a histological level.

Keywords: MR diffusion tensor imaging; MR diffusion tensor tractography; head and neck; postmortem study; ultra-high magnetic field MR.

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Figures

Figure 1
Figure 1
Pictures of the representative specimens. Measures are in centimeters. The top is the cranial side [Color figure can be viewed at http://wileyonlinelibrary.com]
Figure 2
Figure 2
Scheme of the anatomy of the human neck. Black frame represents the approximate area dissected in this study. Blue structure is internal jugular vein (IJV), red is carotid artery (ICA: internal carotid artery, ECA: external carotid artery). Yellow lines represent the nerves. (a: hypoglossal nerve, b: vagus nerve, c: glossopharyngeal nerve, d: spinal accessory nerve) [Color figure can be viewed at http://wileyonlinelibrary.com]
Figure 3
Figure 3
The diffusion tensor tractography fusion with artery structure obtained from CT. Right side neck. Sample number 1. a, The hypoglossal nerve; b, the vagus nerve; c, the glossopharyngeal nerve; and d, the spinal accessory nerve. ECA, external carotid artery; ICA, internal carotid artery [Color figure can be viewed at http://wileyonlinelibrary.com]
Figure 4
Figure 4
The diffusion tensor tractography fusion with artery structure obtained from CT. Right side neck. Sample number 2. a, The hypoglossal nerve; b, the vagus nerve; and c, the glossopharyngeal nerve. ECA, external carotid artery; ICA, internal carotid artery [Color figure can be viewed at http://wileyonlinelibrary.com]
Figure 5
Figure 5
A, The approximate level of the axial slices. B, The axial reconstruction of the MRI revealed multiple fibers running near the carotid sheath. C, Immunostaining of S‐100 confirmed that the fibers were compatible with nerves [Color figure can be viewed at http://wileyonlinelibrary.com]
Figure 6
Figure 6
A, The axial slice of the MRI at the level near the bifurcation. Multiple fibers are seen to run towards the bifurcation (yellow circle). B, Hematoxylin‐eosin staining of the same specimen with a low power field. C, Hematoxylin‐eosin staining. The high power field of the yellow circle in B showing structures similar to the carotid body. D, The S‐100 immunostaining. High power field. Same slice of figure C [Color figure can be viewed at http://wileyonlinelibrary.com]
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