3DSlicer重建技术在原发性三叉神经痛显微血管减压术的应用  

Application of 3D Slicer reconstruction technology in microvascular decompression for primary trigeminal neuralgia

作　　者：张明辉 杨呈浩[1] 罗飞[1] 邓云良[1] 丁昊[1] Zhang Minghui;Yang Chenghao;Luo Fei;Deng Yunliang;Ding Hao(Department of Neurosurgery,Zigong Fourth People's Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]自贡市第四人民医院神经外科,四川自贡643000

出　　处：《中国微侵袭神经外科杂志》2023年第12期55-58,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的探讨3D Slicer重建技术在原发性三叉神经痛(primary trigeminal neuralgia,PTN)显微血管减压手术(microvascular decompression,MVD)中的应用价值。方法回顾性分析76例PTN患者病例资料。通过3D Slicer软件于术前完成主要血管、三叉神经、面听神经及脑干的三维影像重建,并行MVD治疗,重建影像并与术中发现进行对比评价。结果对比术中发现,术前重建影像辨别责任血管准确性达94.7%(72/76),Kappa检验提示两者具有高度一致性(Kappa系数=0.956,P<0.001)。重建影像对于神经受压程度的判断准确性为71.1%(54/76),Kappa检验提示两者一致性一般(Kappa系数=0.495)。卡方检验显示重建影像与术中发现的神经受压程度差异具有统计学意义(P<0.001),MVD术中发现神经受压程度明显高于重建影像所示。结论3D Slicer重建技术能够清晰、准确展示PTN患者神经血管关系,基本实现术中神经血管关系的术前可视化,在MVD具有一定应用价值。但该技术对于细微结构展示能力稍显不足。Objective To investigate the application value of 3D Slicer reconstruction technology in microvascular decompression(MVD)surgery for primary trigeminal neuralgia(PTN).Methods A retrospective analysis was conducted on the medical records of 76 patients with PTN.Three-dimensional(3D)image reconstruction of major vessels,trigeminal nerve,facial nerve,cochlear nerve,and brainstem was performed preoperatively using 3D Slicer software.MVD was then performed,and the reconstructed images were compared and evaluated against intraoperative findings.Results Compared with intraoperative findings,the preoperative reconstructed images accurately identified the offending vessels in 94.7%(72/76)of cases.The Kappa test indicated a high degree of consistency between the two(Kappa coefficient=0.956,P<0.001).The accuracy of the reconstructed images in assessing the degree of nerve compression was 71.1%(54/76),with the Kappa test showing moderate consistency(Kappa coefficient=0.495).The chi-square test revealed a statistically significant difference in the degree of nerve compression between the reconstructed images and intraoperative findings(P<0.001),with the intraoperative findings indicating a higher degree of nerve compression than that depicted in the reconstructed images.Conclusion 3D Slicer reconstruction technology can clearly and accurately demonstrate the neurovascular relationships in PTN patients,essentially achieving preoperative visualization of neurovascular relationships during MVD,demonstrating its value in clinical application.However,the technology exhibits some limitations in depicting fine structural details.

关 键 词：三叉神经痛 显微血管减压术 3D Slicer 重建技术 

分 类 号：R745.11[医药卫生—神经病学与精神病学]