Neurovascular three-dimensional reconstruction in preoperative diagnosis of neurovascular relations and offending arteries in patients with vertebrobasilar dolichoectasia complicated with hemifacial spasm
10.3760/cma.j.cn115354-20200814-00648
- VernacularTitle:神经血管三维重建在术前诊断VBD合并HFS患者神经血管关系和责任血管中的应用
- Author:
Hailiang SHI
1
;
Yang LI
;
Wenchang GUO
;
Yihui DU
;
Haowei SHI
;
Tao QIAN
Author Information
1. 河北省人民医院神经外一科，石家庄 050057
- Keywords:
Hemifacial spasm;
Vertebrobasilar doli1choectasia;
Three-dimensional reconstruction
- From:
Chinese Journal of Neuromedicine
2020;19(12):1194-1199
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the application value of neurovascular three-dimensional (3D) reconstruction with 3D-slicer software in the preoperative diagnosis of neurovascular relations and offending arteries in patients with vertebrobasilar dilatation (VBD) complicated with facial muscle spasm (HFS).Methods:The clinical data of 42 patients with VBD complicated with HFS accepted microvascular decompression (MVD) in our hospital from January 2016 to February 2019 were retrospectively analyzed. The data of skull 3D-TOF MR angiography and 3D-FiESTA MR imaging were imported into 3D-slicer software to establish 3D models of the blood vessels, brain stem and facial auditory nerves of the patients before surgery. The neurovascular relations and offending arteries found during surgery were compared with those diagnosed by 3D-TOF MR angiography combined with 3D-FiESTA MR imaging and 3D models.Results:The consistencies of neurovascular relations and offending arteries found during surgery and those showed by 3D models were good ( Kappa=0.889, P=0.000; Kappa=0.869, P=0.000). The consistency of neurovascular relations showed by 3D models and those diagnosed by 3D-TOF MR angiography combined with 3D-FiESTA MR imaging was good( Kappa=0.809, P=0.000); there was no significant difference between the two methods in diagnosing neurovascular relations ( McNemar-Bowker=5.000, P=0.082). The consistency of offending arteries showed by 3D models and those diagnosed by 3D-TOF MR angiography combined with 3D-FiESTA MR imaging was poor ( Kappa=0.336, P=0.000); there was significant difference between the two methods in diagnosing offending arteries ( McNemar-Bowker=23.000, P=0.000). Conclusion:The 3D-slicer software is used to perform 3D simultaneous reconstruction of blood vessels, nerves and brain stem in the cerebellopontine angle, and the results are highly consistent with surgical findings; 3D-slicer software is more helpful than 3D-TOF MR angiography combined with 3D-FiESTA MR imaging in identification of offending arteries, surgical risk assessment and surgical strategy formulation in patients with VBD complicated with HFS.
