基于3D Slicer的多模态影像融合技术及神经电生理监测在面肌痉挛微血管减压术中的应用  

Application of 3D Slicer based multimodal image fusion technology and neuroelectrophysiologi⁃cal monitoring in microvascular decompression surgery for facial spasm

作　　者：刘文浩[1] 叶敏[1] 张文波[1] 梁明礼[1] 范伟雄[1] LIU Wenhao;YE Min;ZHANG Wenbo;LIANG Mingli;FAN Weixiong(Meizhou People’s Hospital,Meizhou 514000,China)

机构地区：[1]梅州市人民医院,广东梅州514000

出　　处：《中国实用神经疾病杂志》2024年第8期1033-1036,共4页Chinese Journal of Practical Nervous Diseases

基　　金：2022年度梅州市社会发展科技计划项目(编号:2022C0301103)。

摘　　要：目的探讨基于3D Slicer的多模态影像融合技术及神经电生理监测在面肌痉挛微血管减压术中的应用价值。方法采用回顾性分析法,选取41例行血管减压术的面肌痉挛患者为研究对象。术前通过3D Slicer软件对责任血管进行多模态影像融合分析,确定手术方案,术中进行神经电生理监测以判断减压。观察手术效果并追踪术后复发情况。结果术前建模图像发现40例存在微血管压迫,1例未见微血管压迫。未见微血管压迫的1例经术中证实为岩静脉压迫,1例小脑前下动脉经术中证实为小脑上动脉,其余责任血管判定均与术中所见一致。术前建模图像的责任血管判定正确39例,正确率为95%。41例患者经手术治疗后症状均完全缓解,完全缓解率为100%。术后住院期间1例发生面瘫,1例发生听力下降,经对症处理后很快缓解,术后随访3~36个月无复发。结论在面肌痉挛微血管减压术中联合应用多模态影像融合技术可直观了解责任血管及周围重要结构解剖情况,配合神经电生理监测可避免术中减压过度或不充分的情况,两项技术的联合应用可有效提高手术疗效。Objective To investigate the application value of multimodal image fusion technology and neuroelectrophysiological monitoring based on 3D slicer in microvascular decompression surgery for facial spasm.Methods This was a retrospective study,41 patients with facial spasm who underwent vascular decompression surgery were selected as the study subjects.Before surgery,multimodal image fusion analysis was performed on the responsible vessel using 3D slicer software to determine the surgical plan.Neuroelectrophysiological monitoring was performed during surgery to determine decompression.The surgical effect and track postoperative recurrence were observed.Results Pre-operative modeling images revealed microvascular compression in 40 cases and no microvascular compression in 1 case.One case without microvascular compression was confirmed as petrosal vein compression during surgery,while 1 case of superior cerebellar artery was confirmed as posterior inferior cerebellar artery during surgery.The determination of other responsible vessels was consistent with the findings during surgery.Thirty-nine cases were correctly identified as responsible vessels in preoperative modeling images,with a accuracy rate of 95.00%.The symptoms of 41 patients were completely relieved after surgical treatment,with a complete remission rate of 100%.During the postoperative hospitalization,1 patient experienced facial paralysis and 1 patient experienced hearing loss,which quickly resolved after symptomatic treatment.Postoperative follow-up for 3-36 months showed no recurrence during the follow-up period.Conclusion The combined application of multimodal image fusion technology in microvascular decompression surgery for facial spasm can intuitively understand the anatomical situation of the responsible blood vessels and important surrounding structures.Combined with neuroelectrophysiological monitoring can avoid excessive or insufficient decompression during surgery.The combined application of the two technologies can effectively improve the surg

关 键 词：微血管减压术 多模态影像融合 神经电生理监测 面肌痉挛 责任血管 磁共振成像 

分 类 号：R745.12[医药卫生—神经病学与精神病学]