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ACR Appropriateness Criteria® Cranial Neuropathy.

, Bruno Policeni1, Amanda S Corey2

  • 1Principal Author and Panel Vice Chair, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

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|November 6, 2017
PubMed
Summary

Diagnosing cranial neuropathy requires comprehensive imaging, with MRI as the preferred method, complemented by CT for bone evaluation. Contrast-enhanced studies are crucial for detecting neoplastic and inflammatory lesions.

Keywords:
AUCAppropriate Use CriteriaAppropriateness CriteriaCTCranial nervesCranial neuropathyMRISkull base

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Area of Science:

  • Radiology
  • Neurology

Background:

  • Cranial neuropathy evaluation is complex due to diverse nerve pathways and anatomy.
  • Radiological assessment necessitates imaging the entire cranial nerve course.

Purpose of the Study:

  • To outline optimal radiological evaluation strategies for cranial neuropathies.
  • To highlight the roles of MRI and CT in diagnosing these conditions.

Main Methods:

  • Review of imaging modalities, primarily MRI and CT.
  • Application of evidence-based guidelines, including the American College of Radiology Appropriateness Criteria.
  • Utilizing methodologies like RAND/UCLA and GRADE for guideline development.

Main Results:

  • MRI is the primary imaging modality for cranial nerves.
  • CT plays a complementary role, especially for bony structures.
  • Contrast-enhanced MRI is preferred for identifying neoplastic and inflammatory lesions.

Conclusions:

  • A systematic radiological approach, guided by evidence-based criteria, is essential for diagnosing cranial neuropathies.
  • Expert opinion supplements evidence in ambiguous cases, guiding appropriate imaging and treatment decisions.