3D Slicer三维重建技术联合LSR监测在面肌痉挛微血管减压术中的应用  

Application of 3D reconstruction technique using 3D Slicer software combined with LSR monitoring to microvascular decompression for patients with hemifacial spasm

作　　者：刘璐 王春琳 刘家传 徐燊 柯慧 袁杰 胡满苗 LIU Lu;WANG Chun-lin;LIU Jia-chuan;XU Shen;KE Hui;YUAN Jie;HU Man-miao(PLA Clinical College,Anhui Medical University,Hefei 230001,China;Department of Neurosurgery,The 901st Hospital of Joint Logistic Support Force,PLA,Hefei 230001,China)

机构地区：[1]安徽医科大学解放军临床学院,合肥230001 [2]中国人民解放军联勤保障部队第九〇一医院神经外科,合肥230001

出　　处：《中国临床神经外科杂志》2023年第3期160-163,共4页Chinese Journal of Clinical Neurosurgery

基　　金：安徽省重点研究和开发计划项目(201904a07020108)。

摘　　要：目的探讨3D Slicer三维重建技术联合侧向扩散反应(LSR)监测在面肌痉挛(HFS)微血管减压术(MVD)中的应用效果。方法回顾性分析2015年4月至2021年6月3D Slicer三维重建技术联合LSR监测下行MVD治疗的40例HFS的临床资料。术前行3D-FIESTA和3D-TOF MRA检查,根据3D-Slier软件三维重建结果进行术前评估,术中行LSR监测。结果3D-FIESTA和3D-TOF MRA检查判断神经血管关系、识别责任血管与术中所见的一致性一般(K值分别为0.389、0.492;P<0.05),3D Slier三维重建技术判断神经血管关系、识别责任血管与术中所见的一致性较好(K值分别为0.691、0.778;P<0.001)。术中LSR消失33例,LSR未消失7例。术后随访1年,术中LSR消失病人有效率(96.7%,32/33)较LSR未消失病人(57.1%,4/7)明显增高(P<0.05)。结论对HFS病人,3D Slier三维重建技术有助于提高术前判断神经血管关系、识别责任血管的准确率,术中LSR监测有助于评估病人的预后。Objective To investigate the application value of 3D reconstruction using 3D Slicer software combined with lateral diffusion response(LSR)monitoring to microvascular decompression(MVD)for patients with hemifacial spasm(HFS).Methods The clinical data of 40 patients with HFS who were treated with MVD under guidance of 3D reconstruction technique using 3D Slicer software combined with LSR monitoring from April 2015 to June 2021 were retrospectively analyzed.Preoperative 3D-FIESTA and 3D-TOF MRA examinations were performed.Preoperative evaluation was performed according to the 3D reconstruction results of 3D-Slier software,and intraoperative LSR monitoring was performed.Results For determining the neurovascular relationship and identifying the responsible vessels,the results of 3D-FIESTA and 3D-TOF MRA were generally consistent with intraoperative findings(K values were 0.389 and 0.492,respectively;P<0.05),while 3D reconstruction technique using 3D Slier software was in good agreement with intraoperative findings(K values were 0.691 and 0.778,respectively;P<0.001).LSR disappeared in 33 patients and did not in 7 patients during the operation.The one-year follow-up showed that the effective rate of patients with LSR disappearance(96.7%,32/33)was significantly higher than that(57.1%,4/7)of patients without LSR disappearance(P<0.05).Conclusions For patients with HFS undergoing MVD,3D reconstruction technique using 3D Slier software can improve the accuracy of identifying neurovascular relationship and responsible vessels before the surgery,and intraoperative LSR monitoring can help evaluate the patients prognoses.

关 键 词：面肌痉挛 微血管减压术 3D Slier三维重建技术 侧向扩散反应 

分 类 号：R745.12[医药卫生—神经病学与精神病学] R651.11[医药卫生—临床医学]