Visibility of cranial nerves at MRI

In order to assess the value of MRI in the depiction of intracranial nerves, we retrospectively reviewed 60 patients investigated over a 2-year period. The purposes of this study were: 1) to determine the score of MRI in detecting cranial nerves III to XII, and 2) to establish accurate landmarks for easy detection of these nerves. Cranial nerves III, V, VII and VIII are well seen (70 to 100%), very often on axial, sagittal and coronal sections. Nerves IX to XII are correctly studied only on axial planes (81 and 83%), but it is difficult to distinguish between the vagus nerve and the glossopharyngeal and spinal nerves. Due to their oblique direction and small size, nerves IV and VI are seldom visualized. The most important landmarks are the chiasma, the colliculi, Meckel's cavity, the internal auditory canal, the jugular foramen, the hypoglossal canal and the brainstem structures. We suggest the following scanning technique: short spin-echo sequences (TR 600 ms, TE 20 ms), 3 to 5 mm thick contiguous sections, 16 to 20 cm field of view with 4 or 2 excitations respectively, 256 x 256 matrix, and at least one acquisition plane (axial plane), but preferably two or three planes. MRI is a sensitive examination in the recognition of cranial nerves. It should be the first-step exploratory procedure in patients with cranial nerve pathology.