• Yoshio Kitazume, Isamu Ohashi, Takashi Katayama, Atsunobu Tsunoda, Seiji Kishimoto, and Mariko Negi.
• From the *Department of Radiology, Tokyo Medical and Dental University Hospital; †Department of Radiology, Omori Red Cross Hospital; and Departments of ‡Otolaryngology, §Head & Neck Surgery, and ∥Human Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan.
• J Comput Assist Tomogr. 2014 Nov 1; 38 (6): 930-5.

ObjectiveThe aim of this study was to assess the feasibility of diffusion-weighted (DW) magnetic resonance neurography (MRN) for determining the originating nerve of parapharyngeal schwannomas preoperatively.MethodsSix patients who underwent DW-MRN preoperatively for a parapharyngeal schwannoma were studied. Prediction of the originating nerve was performed. With the conventional method, a tumor showing "separation" between the internal jugular vein and carotid artery was determined to originate from the vagus nerve, with "no separation" from the sympathetic chain. With DW-MRN, the relationships between the vagus nerve and sympathetic chain to the tumor were characterized as "connected" or "dislocated." A nerve connected to the tumor was determined as the origin.ResultsSurgeries revealed that the origins included 1 vagus nerve and 5 sympathetic chains. Using a conventional method, all 6 cases were diagnosed correctly, whereas DW-MRN successfully predicted only 4 cases with a sympathetic chain origin.ConclusionsThe DW-MRN is a feasible approach for determining an originating nerve.

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