High-resolution MR of the intraparotid facial nerve and parotid duct

Abstract

Purpose: To describe a high-resolution MR imaging technique that depicts the complex anatomy of the region of the parotid gland, focusing on the intraparotid components of the facial nerve and parotid duct.

Methods: High-resolution T1-weighted images of the parotid gland were acquired with a prototype three-dimensional Fourier transform gradient-echo sequence that permits a very short echo time (4.2 milliseconds) by using a modified phase-encoded time-reduced acquisition scheme. The sequences were obtained at 1.5 T with a head and neck coil. Postprocessed multiplanar, curved and volumetric images were obtained. The most clinically useful images were acquired at parameters of 40/4.2 (TR/TEeff) a flip of 30 degrees, a field of view of 18 to 20 cm, a matrix of 512 x 288 or 512 x 256, an axial plane, 60 images, no gaps, and a section thickness of 1.5 mm. Eighteen healthy subjects were examined. The position of the facial nerve within the parotid gland was determined by identifying the facial nerve in the stylomastoid foramen and then following it on sequential sections through the parotid gland. Curved reformations were used to confirm the visibility of the nerve. A similar technique was used for the parotid duct.

Results: The image contrast obtained was similar to that of standard spin-echo T1-weighted images. The parotid gland showed intermediate signal intensity while the fat spaces showed high signal intensity. The vessels had variable signal intensity depending on saturation. The cerebrospinal fluid, nerves, muscles, and ducts had lower signal intensity. In all 18 subjects, the facial nerve from the brain stem to the parotid gland, and the parotid duct from the mouth to the hilus of the gland were seen bilaterally. The proximal intraparotid facial nerve to the level of the retromandibular vein was seen in 72% of the subjects and the main intraparotid ducts were seen in 66% of the subjects.

Conclusion: High-resolution MR imaging offers simultaneous display of most of the important structures in the region of the parotid gland, including the intraparotid duct and facial nerve.