MRI of inner ear anatomy using 3D MP-RAGE and 3D CISS sequences

The aim of this study was to compare contrast enhanced 3D MP-RAGE (magnetization prepared rapid gradient echo), unenhanced 3D MP-RAGE and 3D CISS (constructive interference in steady state) in the evaluation of anatomical detail of the inner ear and facial nerve. 60 persons with no abnormalities and no or non-specific symptoms were examined with MRI. All examinations were performed using a 1.5 T MR unit. The detectability of anatomical details was evaluated by agreement of three radiologists. Statistical evaluation of the results was achieved by the two-tailed Wilcoxon's test. In 86-95% of the cases, 3D CISS resulted in excellent visibility of the basal and second turn and apex of the cochlea, the vestibule and semicircular canals, as well as the nerves within the internal auditory canal. There was a significantly better visualization with CISS than with MP-RAGE. Detectability of the extrameatal facial nerve was best using contrast enhanced 3D MP-RAGE in 91-96% of the cases (labyrinthine segment 96.7%; geniculate ganglion 95%; tympanic segment 91.7%; vertical segment 95%). The detection of the meatal seventh nerve was best using CISS, whilst unenhanced MP-RAGE gave significantly better results than contrast enhanced MP-RAGE. These results suggest that unenhanced and contrast enhanced 3D MP-RAGE and 3D CISS sequences are complementary and not alternative MRI techniques. Both T1 and T2 weighted 3D MR imaging of the temporal bone is of advantage when compared with 2D MR sequences due to improved contrast, geometrical resolution and the possibility of adequate reconstruction of anatomical structures.