| 多模态虚拟重建对面神经显微血管减压术的术前指导价值 |
| 投稿时间：2017-12-13 修订日期：2018-01-03 点此下载全文 |
| 引用本文：李美辰,崔斌,林贵军,郭辉.多模态虚拟重建对面神经显微血管减压术的术前指导价值[J].医学研究杂志,2018,47(10):114-117,106 |
| DOI：
10.11969/j.issn.1673-548X.2018.10.031 |
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| 中文摘要:目的 探讨基于三维时间飞跃法血管成像序列（3D-TOF）与三维可变翻转角快速自旋回波序列（3D-SPACE）的多模态虚拟重建图像对显微血管减压术的术前指导意义。方法 分析笔者医院连续收治的45例需行显微血管减压术的面肌痉挛患者，术前对其行3D-TOF、3D-SPACE两种序列扫描并应用Neuro Tech软件进行双序列三维重建，将所得图像与术野所见进行对比，进而分析三维重建的优劣性。结果 45例手术患者中38例可见面神经出脑干区（root exit zoom，REZ）压迫，7例可见直接接触压迫。三维重建所示责任血管为小脑前下动脉压迫27例、小脑后下动脉压迫12例、两者均有压迫6例；其中存在椎动脉压迫12例。术中所见责任血管为小脑前下动脉26例、小脑后下动脉16例、两者均有压迫3例；其中存在椎动脉压迫12例。对比术中视野与三维重建图像的神经血管相对关系的一致性，两者一致性差异有统计学意义（kappa值>0.7）。结论 通过3D-TOF联合3D-SPACE序列的多模态虚拟重建对于脑内结构显像清楚，特别是可以将面神经和周围血管的解剖关系更加直观的显示。该方法可应用于术前手术难度的评估、个体化手术方案的制定，对患者术后并发症的控制有重要意义。 |
| 中文关键词:显微血管减压术 磁共振成像 责任血管 多模态重建 |
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| Preoperative Guiding Value of Multimodal Virtue Reconstruction for Microvascular Decompression of Facial Nerves |
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| Abstract:Objective To investigate the significance of multimodal reconstruction based on MRI three-dimensional time of flight angiographic sequence (3D-TOF) combined with three-dimensional sampling perfection with application optimized contrast using different flip angle evolutions(3D-SPACE) in directing microvascular decompression(MVD) before operation. Methods We continuously admitted 45 hemifacial spasm(HFS) patients who need microvascular decompression. According to the Neuro Tech software, 3D structures were reconstructed by 3D TOF and 3D SPACE sequences and were compared with surgical findings. Results The arterial compression or contact on the facial nerve root exit zoom (REZ) was found in 45 patients. The 3D reconstruction images showed that the responsible blood vessels were anterior inferior cerebellar artery in 27, in posterior inferior cerebellar artery in 12, both vessels in 6 and had 12 vertebral artery compression. The surgical findings showed that the responsible blood vessels were anterior inferior cerebellar artery in 26, posterior inferior cerebellar artery in 16, both vessels in 3 and had 12 vertebral artery compression. The consistency between 3D structures and surgical images was statistically significant (kappa value>0.7). Conclusion The 3D structure images based on 3D TOF and 3D SPACE sequences can intuitively reveal the anatomic relationship of blood vessels and nerves in brain. This method provide possibility in predicting operation difficulty and developing individualized surgical procedures. |
| keywords:Microvascular decompression Magnetic resonance imaging Responsible vascular Multimodal reconstruction |
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