MRI-Visible Anatomy of the Brainstem

Timothy M Shepherd; Michael J Hoch

doi:10.1016/j.nic.2022.04.003

MRI-Visible Anatomy of the Brainstem

Neuroimaging Clin N Am. 2022 Aug;32(3):553-564. doi: 10.1016/j.nic.2022.04.003.

Authors

Timothy M Shepherd¹, Michael J Hoch²

Affiliations

¹ Department of Radiology, New York University Langone School of Medicine, 660 First Avenue, Room 230D, New York, NY 10016, USA. Electronic address: timothy.shepherd@nyulangone.org.
² Department of Radiology, University of Pennsylvania, 3400 Spruce Street, Suite 130, Philadelphia, PA 19104, USA. Electronic address: https://twitter.com/RVUhound.

PMID: 35843662
DOI: 10.1016/j.nic.2022.04.003

Abstract

Human brainstem internal anatomy is intricate, complex, and essential to normal brain function. The brainstem is affected by stroke, multiple sclerosis, and most neurodegenerative diseases-a 1-mm focus of pathologic condition can have profound clinical consequences. Unfortunately, detailed internal brainstem anatomy is difficult to see with conventional MRI sequences. We review normal brainstem anatomy visualized on widely available clinical 3-T MRI scanners using fast gray matter acquisition T1 inversion recovery, probabilistic diffusion tractography, neuromelanin, and susceptibility-weighted imaging. Better anatomic localization using these recent innovations improves our ability to diagnose, localize, and treat brainstem diseases. We aim to provide an accessible review of the most clinically relevant brainstem neuroanatomy.

Keywords: FGATIR; Locus coeruleus; Neuromelanin; Nigrosome; Parkinsonism; Tractography.

Publication types

Review

MeSH terms

Brain / diagnostic imaging
Brain / pathology
Brain Stem* / diagnostic imaging
Diffusion Tensor Imaging / methods
Gray Matter
Humans
Magnetic Resonance Imaging* / methods