High-resolution imaging of the mandibular nerve using 3D double-echo steady-state MRI and a 15-channel mandibular...

To evaluate the feasibility of an optimized high-resolution three-dimensional (3D) double-echo steady-state (DESS) magnetic resonance imaging (MRI) sequence, combined with a dedicated 15-channel mandibular coil, on 3T MRI for visualization of the mandibular nerve and its six peripheral branches in healthy volunteers.

Images from 21 participants were assessed by three readers with varying levels of experience and medical specialties. Overall image quality, artifact presence, and nerve continuity across the proximal and distal segments of the masseteric, buccal, auriculotemporal, lingual, inferior alveolar, and mylohyoid nerves were evaluated using 5-point visual rating scales (5 = best, 1 = worst). Descriptive statistics and inter-reader agreement using Krippendorff's alpha (α) were calculated.

Image quality was consistently rated as excellent with minimal artifacts (median 5, IQR 5-5) and high inter-reader agreement (α = 0.87-0.92). Continuous visualization of proximal and distal segments was achieved for most branches, particularly the inferior alveolar and lingual nerves (median 5, IQR 5-5). Visualization of thinner branches, including the masseteric, mylohyoid, and buccal nerves, was more challenging (median 4-4.5). Overall inter-reader agreement for nerve continuity assessment ranged from good to perfect (α = 0.79-1.0).

An optimized high-resolution 3D-DESS sequence, combined with a dedicated mandibular coil, enables reliable and reproducible visualization of the mandibular nerve and its peripheral branches.