3D T1 VIBE Beats MPRAGE for Intracavernous Cranial Nerve Visualization on MRI

3D T1 VIBE detects intracavernous cranial nerves far better than MPRAGE in neuro-ophthalmic MRI. In 54 exams, VIBE visualized CN V1 in 65–70% vs 6–9% and CN VI in 70–78% vs 19–22% for MPRAGE (all p<0.001), suggesting VIBE should be the preferred sequence.

• Retrospective single-center study; 54 contrast-enhanced coronal MRI exams at 1.5-mm slice thickness evaluated independently by 3 readers (1 neuroradiologist, 2 residents); inter-reader agreement was significant for both sequences (p<0.001).
• CN III visualization was also markedly better with VIBE (96–98% vs 69–74%), and CN V2 improved from 35–44% to 61–72% — both p<0.001 across all readers.
• Key limitations: retrospective design, single center, small sample (n=54 exams), and no correlation with surgical or pathologic confirmation of nerve involvement.

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