Onoda Keisuke, Satoh Toru, Miyosnhi Yasuyuki, Tokunaga Koji, Sugiu Kenji, Date Isao
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama-city, Okayama 700-8558, Japan.
No Shinkei Geka. 2006 Aug;34(8):785-91.
The preoperative assessment of microvascular decompression (MVD) for hemifacial spasm has been performed with MRI, but assessment of the compressive status by 2D imaging has a number of limitations. We used a fusion image of the 3D MR cisternogram and co-registered 3D MR angiogram, reconstructed from MR cisternogram, obtained by 3D fast spin-echo sequence, and MR angiography, 3D time-of-flight and spoiled-gradient recalled sequences, for the preoperative assessment of the offending artery in 10 patients with hemifacial spasm. The anatomical relationship of the nerve-vessel complex was assessed on the simulated images, and compared with the intraoperative findings. The fusion image of the 3D MR cisternogram/angiogram depicted contours of the brain, nerves, and vessels clearly, and that allowed precise assessment of the pathogenic compression of the facial nerve by the offending vessels, comparative to the operative findings. The fusion imaging of the 3D MR cisternogram/angiogram may provide useful information in the surgical planning of MVD for hemifacial spasm.
微血管减压术(MVD)治疗面肌痉挛的术前评估已采用磁共振成像(MRI)进行,但通过二维成像评估压迫状态存在诸多局限性。我们使用了三维磁共振脑池造影融合图像和共同配准的三维磁共振血管造影,三维磁共振脑池造影由三维快速自旋回波序列获得的磁共振脑池造影重建而成,磁共振血管造影采用三维时间飞跃法和扰相梯度回波序列,用于10例面肌痉挛患者术前对责任动脉的评估。在模拟图像上评估神经血管复合体的解剖关系,并与术中发现进行比较。三维磁共振脑池造影/血管造影融合图像清晰地显示了脑、神经和血管的轮廓,与手术结果相比,这使得能够精确评估责任血管对面神经的病理性压迫。三维磁共振脑池造影/血管造影融合成像可能为面肌痉挛微血管减压术的手术规划提供有用信息。