High Resolution Three-Dimensional MR Imaging of the Skull Base: Compartments, Boundaries, and Critical Structures

Ari Meir Blitz; Nafi Aygun; Daniel A Herzka; Masaru Ishii; Gary L Gallia

doi:10.1016/j.rcl.2016.08.011

High Resolution Three-Dimensional MR Imaging of the Skull Base: Compartments, Boundaries, and Critical Structures

Radiol Clin North Am. 2017 Jan;55(1):17-30. doi: 10.1016/j.rcl.2016.08.011.

Authors

Ari Meir Blitz¹, Nafi Aygun², Daniel A Herzka³, Masaru Ishii⁴, Gary L Gallia⁵

Affiliations

¹ Division of Neuroradiology, Department of Radiology and Radiological Science, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA. Electronic address: ablitz1@jhmi.edu.
² Division of Neuroradiology, Department of Radiology and Radiological Science, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA.
³ Department of Biomedical Engineering, Johns Hopkins Hospital, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD 21287, USA.
⁴ Department of Otolaryngology, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA.
⁵ Department of Neurosurgery, Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD 21287, USA. Electronic address: ggallia1@jhmi.edu.

PMID: 27890185
DOI: 10.1016/j.rcl.2016.08.011

Abstract

High-resolution 3D MRI of the skull base allows for a more detailed and accurate assessment of normal anatomic structures as well as the location and extent of skull base pathologies than has previously been possible. This article describes the techniques employed for high-resolution skull base MRI including pre- and post-contrast constructive interference in the steady state (CISS) imaging and their utility for evaluation of the many small structures of the skull base, focusing on those regions and concepts most pertinent to localization of cranial nerve palsies and in providing pre-operative guidance and post-operative assessment. The concept of skull base compartments as a means of conceptualizing the various layers of the skull base and their importance in assessment of masses of the skull base is discussed.

Keywords: CISS; Cranial nerves; High-resolution 3D MR imaging; Skull base MR imaging; Skull base compartments.

Publication types

Review

MeSH terms

Brain / diagnostic imaging
Brain / surgery
Humans
Imaging, Three-Dimensional / methods*
Magnetic Resonance Imaging / methods*
Minimally Invasive Surgical Procedures / methods
Neurosurgical Procedures / methods*
Otorhinolaryngologic Surgical Procedures / methods
Skull Base / diagnostic imaging*
Skull Base / surgery*
Surgery, Computer-Assisted / methods*
Transanal Endoscopic Surgery / methods