3D-Slicer软件评估面肌痉挛神经血管关系的研究  

Study of evaluating the neurovascular relationship with 3D-Slicer software in hemifacial spasm

作　　者：王银占 钱涛[2] Wang Yinzhan;Qian Tao(Graduate College,Hebei Medical University,Shijiazhuang,Hebei 050017,China;Department ofNeurosurgery,Hebei General Hospital,Shijiazhuang,Hebei 050051,China)

机构地区：[1]河北医科大学研究生学院,石家庄050017 [2]河北省人民医院神经外科,石家庄050051

出　　处：《中国微侵袭神经外科杂志》2018年第9期409-412,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的对比分析3D-FIESTA联合3D-TOF MRA序列与3D-Slicer软件评估面肌痉挛神经血管关系的准确性。方法回顾性分析40例显微血管减压术(MVD)治疗面肌痉挛病人的临床资料,术前均行3D-FIESTA和3D-TOF MRA序列检查,并应用3D-Slicer软件进行三维重建评估神经血管关系,并预测责任血管,然后与术中所见进行比较。结果评估神经血管关系时,3D-FIESTA联合3D-TOF MRA序列与术中所见一致性的K值为0.263,三维重建与术中所见一致性的K值为0.633,二者无统计学差异(χ~2=9.363,P=0.053);预测责任血管时,3D-FIESTA联合3D-TOF MRA序列与术中所见一致性的K值为0.643,三维重建与术中所见一致性的K值为0.921,二者有统计学差异(χ~2=188.408,P=0.000)。3D-FIESTA联合3D-TOF MRA序列评估神经血管关系的灵敏度和特异度分别为89.7%和100%,而三维重建均为100%。结论使用3D-Slicer软件术前评估面肌痉挛病人神经血管关系及预测责任血管,比3D-FIESTA联合3D-TOF MRA序列更准确,与术中所见更接近,对术前制定手术计划更有帮助。Objective To compare the accuracy between 3 D-FIESTA combined with 3 D-TOF MRA and 3 D-Slicer software for evaluating the neurovascular relationship for patients with hemifacial spasm. Methods Clinical data of 40 patients with hemifacial spasm undergoing microsurgical vascular decompression（ MVD） were analyzed retrospectively. 3 D-FIESTA and 3 D-TOF MRA sequence scans were performed before the operation. The neurovascular relationship and the offending vessel were evaluated by three-dimensional reconstruction based on 3 D-Slicer software, then, the results compared with the surgical finding. Results The consistency of K value between 3 D-FIESTA combined with 3 D-TOF MRA and surgical finding in evaluating the neurovascular relationship was 0.263, and that was 0.633 between the three-dimensional reconstruction and surgical finding, there was no significant difference between the two methods（χ2= 9.363, P = 0.053）. The consistency of K value between 3 D-FIESTA combined with 3 D-TOF MRA and surgical finding in determining the offending vessel was 0.643, and that was 0.921 between the three-dimensional reconstruction and surgical finding, there was a significant difference between them（χ2= 188.408, P = 0.000）. The sensitivity and specificity of 3 D-FIESTA combined with 3 D-TOF MRA in evaluating the neurovascular relationship were 89.7% and 100% respectively, while three-dimensional reconstruction were both 100%. Conclusions 3 D-Slicer software is more accurate than 3 D-FIESTA combined with3 D-TOF MRA in evaluating the neurovascular relationship and predicting the offending vessel before the surgery for patients with hemifacial spasm, and it is more consistent with the surgical findings and more helpful in preoperative planning.

关 键 词：面部单侧痉挛 神经血管关系 3D-Slicer软件 三维重建 

分 类 号：R745.12[医药卫生—神经病学与精神病学]