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An Interactive, Ultra-High Resolution Magnetic Resonance Neurography Atlas of the Face and Neck
Sophie Queler
*, Ek Tsoon Tan, Yenpo Lin, Philip Colucci, Darryl Sneag
Hospital for Special Surgery, Brooklyn, NY
BACKGROUND: High-resolution MRI of peripheral nerves, or magnetic resonance (MR) neurography, can facilitate nerve visualization for surgical planning and post-operative assessment. In the head and neck, early research has shown MR neurography to assist surgical intervention in pathologies affecting the facial, occipital, and trigeminal nerves. MR neurography is currently underutilized in the field of plastic and nerve surgery. Here, we have created a free, online, ultra-high resolution, interactive MR neurography atlas of the face and neck. We aimed to i) demonstrate the feasibility of applying MR neurography within this region, and ii) provide an anatomical reference for clinicians, surgeons and trainees.
METHODS: Volunteers (7F/1M, mean age 25.5 years) underwent 3.0 Tesla MR neurography of the head and neck between September 2021 and April 2024 at 0, 12, 24 and 36 hours post infusion with a low dose of a previously described iron-oxide nanoparticle (ferumoxytol) for vascular suppression (127.5mg iron; half-life=14 hours). 2D and 3D fluid-sensitive, fat-suppressed sequences with submillimeter resolution were reconstructed with a deep-learning algorithm for improved image quality (AIR
TM Recon DL). Three radiologists independently reviewed exams to select the highest quality and most anatomically representative cases.
RESULTS: Excellent vascular suppression was achieved in all 8 subjects. Image stacks were generated for major muscles and nerves in the face and neck. The atlas is being hosted on an institutional server alongside a previously developed brachial plexus atlas (https://www.hss.edu/MRNatlas).
CONCLUSION: This interactive MR neurography atlas depicts the nerves and muscles of the face and neck, demonstrating the feasibility of MR neurography in the head and neck and providing an anatomical reference for plastic surgeons, clinicians and trainees.
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