Assessment of traumatic mandibular nerve using MR neurography sequence: a preliminary study

Area of Science:

• Medical Imaging
• Neurology
• Oral Surgery

Background:

• Iatrogenic mandibular nerve damage from oral procedures presents diagnostic challenges due to a lack of objective methods.
• This ambiguity complicates treatment, compensation, and often leads to medico-legal disputes.

Purpose of the Study:

• To identify discriminating factors for traumatic mandibular nerve injury using a specific MRI protocol.
• To establish objective diagnostic criteria for peripheral trigeminal nerve injury.

Main Methods:

• Twenty-six patients with mandibular nerve trauma underwent specialized MRI sequences (T2 Flex, 3D STIR, DWI with PROPELLER).
• Injured nerves were compared to contralateral healthy nerves, evaluating parameters like FSNR, FNMCNR, SSNR, SNMCNR, ADC, and cross-sectional nerve area.

Main Results:

• The study found that increased FSNR and FNMCNR were significant discriminators of traumatic mandibular nerve injury (p < 0.05).
• The diagnostic performance showed an AUC of 0.712 for FSNR and 0.7056 for FNMCNR, indicating good accuracy.

Conclusions:

• Elevated FSNR and FNMCNR in the applied MRI sequence are accurate indicators of traumatic nerve injury.
• This research provides a foundation for developing advanced models for diagnosing trigeminal nerve trauma in larger patient populations.