title: Trochlear Groove and Trochlear Cistern: Useful Anatomic Landmarks for Identifying the Tentorial Segment of Cranial Nerve IV on MRI.
abstract: OBJECTIVE
  The trochlear groove and trochlear cistern are anatomic landmarks closely associated with the tentorial segment of cranial nerve IV. The purposes of this study were to describe the MR imaging appearances of the trochlear groove and trochlear cistern and to test our hypothesis that knowledge of these anatomic landmarks facilitates identification of cranial nerve IV in routine clinical practice.
  
  
  METHODS
  For this retrospective study, consecutive MR imaging examinations of the sinuses performed in 25 patients (50 sides) at our institution were reviewed. Patient characteristics and study indications were recorded. Three readers performed independent assessments of trochlear groove, cistern, and nerve visibility on coronal images obtained by using a T2-weighted driven equilibrium radiofrequency reset pulse sequence.
  
  
  RESULTS
  Interobserver agreement was 78% for visibility of the trochlear groove, 56% for the trochlear cistern, and 68% for cranial nerve IV. Following consensus review, the trochlear groove was present in 44/50 sides (88%), the trochlear cistern was present in 25/50 sides (50%), and cranial nerve IV was identified in 36/50 sides (72%). When the trochlear groove was present, cranial nerve IV was identified in 35/44 sides (80%), in contrast to 1/6 sides (17%) with no groove (P= .0013). When the trochlear cistern was present, cranial nerve IV was identified in 23/25 sides (92%), in contrast to 13/25 sides (52%) with no cistern (P= .0016).
  
  
  CONCLUSIONS
  The trochlear groove and trochlear cistern are anatomic landmarks that facilitate identification of cranial nerve IV in routine clinical practice.
authors.affiliation: From the Department of Radiology (P.M.B., H.R.K.), Division of Neuroradiology, Massachusetts General Hospital, Boston, Massachusetts paul.m.bunch@gmail.com.
authors.forename: P M
authors.identifier: http://orcid.org/0000-0001-6129-7299
authors.initials: PM
authors.lastname: Bunch
authors.affiliation: From the Department of Radiology (P.M.B., H.R.K.), Division of Neuroradiology, Massachusetts General Hospital, Boston, Massachusetts.|Department of Radiology (H.R.K., D.A.Z., H.D.C.), Massachusetts Eye and Ear, Boston, Massachusetts.
authors.forename: H R
authors.identifier: http://orcid.org/0000-0002-6655-8723
authors.initials: HR
authors.lastname: Kelly
authors.affiliation: Department of Radiology (H.R.K., D.A.Z., H.D.C.), Massachusetts Eye and Ear, Boston, Massachusetts.
authors.forename: D A
authors.identifier: http://orcid.org/0000-0002-0808-307X
authors.initials: DA
authors.lastname: Zander
authors.affiliation: Department of Radiology (H.R.K., D.A.Z., H.D.C.), Massachusetts Eye and Ear, Boston, Massachusetts.
authors.forename: H D
authors.identifier: http://orcid.org/0000-0003-2163-9404
authors.initials: HD
authors.lastname: Curtin
mesh_terms: D000328:Adult; D059925:Anatomic Landmarks; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014321:Trochlear Nerve / Q000000981:diagnostic imaging*