采用三维双回波稳态水兴奋序列磁共振成像（3D-DESS-WE-MRI）可以对颌下腺内面神经（FN）进行可视化。然而，在腮腺切除术前使用3D-DESS-WE-MRI进行FN成像的临床影响尚未探讨。我们比较了接受腮腺切除术的患者中有无术前 3D-DESS-WE-MRI 的临床结果。这项前瞻性、非随机化、单中心研究纳入了296名成年患者，他们接受了腮腺肿瘤的腺切除术，排除了浅表和活动性肿瘤。术前通过 3D-DESS-WE-MRI 对122名患者进行了评估，而174名患者没有进行评估。在120名患者中评估了3D-DESS-WE-MRI 中 FN 的可见度和肿瘤相对于 FN 的位置。利用倾向性分数匹配和逆概率权重矫正手术和肿瘤因素，比较了有无3D-DESS-WE-MRI 的患者的 FN 瘫痪（FNP）率和手术时间。3D-DESS-WE-MRI 能够在大约97.5%的病例（117/120）中鉴定出内颌下腺 FN 的主干、颞肌支和颈肌支。根据磁共振成像评估，在120例中有90.8%（109/120）的病例 FN 的位置与手术发现一致。根据 PSM（奇异比率 2.29 [95% 置信区间［CI］0.64-8.25] 和 2.02 [95% CI: 0.32-12.90]）和 IPTW（奇异比率 1.76 [95% CI: 0.19-16.75] 和 1.94 [95% CI: 0.20-18.49]），有无3D-DESS-WE-MRI 的患者的暂时性和永久性 FNP 率没有显著差异。相反，3D-DESS-WE-MRI 的手术 FN 鉴定时间明显缩短（PSM中位数为25分钟，IPTW中位数为25分钟，P < 0.001）。术前利用3D-DESS-WE-MRI 成像可以促进 FN 解剖学鉴定及其与肿瘤的关系，在腮腺切除术中有助于缩短 FN 鉴定的手术时间，但对术后 FNP 率没有显著影响。Copyright © 2023 The Korean Society of Radiology.

The intra-parotid facial nerve (FN) can be visualized using three-dimensional double-echo steady-state water-excitation sequence magnetic resonance imaging (3D-DESS-WE-MRI). However, the clinical impact of FN imaging using 3D-DESS-WE-MRI before parotidectomy has not yet been explored. We compared the clinical outcomes of parotidectomy in patients with and without preoperative 3D-DESS-WE-MRI.This prospective, non-randomized, single-institution study included 296 adult patients who underwent parotidectomy for parotid tumors, excluding superficial and mobile tumors. Preoperative evaluation with 3D-DESS-WE-MRI was performed in 122 patients, and not performed in 174 patients. FN visibility and tumor location relative to FN on 3D-DESS-WE-MRI were evaluated in 120 patients. Rates of FN palsy (FNP) and operation times were compared between patients with and without 3D-DESS-WE-MRI; propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were used to adjust for surgical and tumor factors.The main trunk, temporofacial branch, and cervicofacial branch of the intra-parotid FN were identified using 3D-DESS-WE-MRI in approximately 97.5% (117/120), 44.2% (53/120), and 25.0% (30/120) of cases, respectively. The tumor location relative to FN, as assessed on magnetic resonance imaging, concurred with surgical findings in 90.8% (109/120) of cases. Rates of temporary and permanent FNP did not vary between patients with and without 3D-DESS-WE-MRI according to PSM (odds ratio, 2.29 [95% confidence interval {CI} 0.64-8.25] and 2.02 [95% CI: 0.32-12.90], respectively) and IPTW (odds ratio, 1.76 [95% CI: 0.19-16.75] and 1.94 [95% CI: 0.20-18.49], respectively). Conversely, operation time for surgical identification of FN was significantly shorter with 3D-DESS-WE-MRI (median, 25 vs. 35 min for PSM and 25 vs. 30 min for IPTW, P < 0.001).Preoperative FN imaging with 3D-DESS-WE-MRI facilitated anatomical identification of FN and its relationship to the tumor during parotidectomy. This modality reduced operation time for FN identification, but did not significantly affect postoperative FNP rates.Copyright © 2023 The Korean Society of Radiology.