CT and MR imaging in the evaluation of vagal neuropathy

The vagus nerve extends from its brain stem nuclei to the viscera of the abdomen. Palpable disease affecting this nerve presents a straightforward imaging problem. When occult lesions cause vagal neuropathy, imaging the entire course of the nerve is an expensive, ineffective use of scanner time. Yet incomplete imaging results in critical delays in diagnosis and treatment. The authors reviewed the records of 45 patients with vagal neuropathy who had undergone CT and/or MR imaging. Based on this record review, they recommend dividing the vagus nerve into proximal and distal functional-anatomic imaging units. Proximal vagal neuropathy is best evaluated on MR imaging, whereas distal vagus nerve disfunction is still best evaluated on CT