弥散张量成像纤维束追踪在听神经瘤切除术中对面神经保护的准确性和结果。

Accuracy and outcomes of diffusion tensor imaging tractography in resection for vestibular schwannoma for facial nerve preservation.

机构信息

Departments of Neurosurgery, United States of America.

Radiation Oncology, Head and Neck Surgery, United States of America; UCLA Jonsson Comprehensive Cancer Center, Ronald Reagan, United States of America; UCLA Medical Center, Los Angeles, CA, United States of America.

出版信息

J Neurol Sci. 2021 Nov 15;430:120006. doi: 10.1016/j.jns.2021.120006. Epub 2021 Sep 25.

DOI:10.1016/j.jns.2021.120006

PMID:34601356

Abstract

BACKGROUND

Impairment of facial nerve (FN) function is a common postoperative complication in surgical resections of Vestibular Schwannomas (VS). Diffusion tensor imaging (DTI) tractography creates in vivo imaging of the anatomical location of white matter tracts that can be preoperatively used to visualize the displaced FN. We present an analysis of patients who underwent DTI tractography imaging prior to VS resection.

METHODS

Patient charts were reviewed from March 2012 to April 2015 who underwent DTI tractography prior to surgical resection for VS. Reliability of this measure was compared to the intraoperative FN location as determined by the surgeon. House Brackmann (HB) score was used to assess facial nerve function.

RESULTS

A total of 11 patients were included with a mean age of 43 years (range: 19-64) and mean follow-up length of 11.9 months (range: 3.1-34.2). The average maximum tumor diameter was 2.82 cm (range: 1.7-4.2). DTI tractography was accurate in 90.9% (10/11) of patients. Postoperatively, 72.7% (8/11) had a HB score of I or II, 18.2% (2/11) had a HB score of III, and 9.1% (1/11) had a HB score of IV.

CONCLUSIONS

Facial nerve visualization for VS resection can be accurately visualized using DTI tractography. This modality may lead to reduction of postoperative FN damage.

摘要

背景

面神经（FN）功能障碍是听神经鞘瘤（VS）手术切除后的常见术后并发症。弥散张量成像（DTI）示踪术可对脑白质束的解剖位置进行活体成像，可在术前用于观察移位的 FN。我们分析了术前接受 VS 切除的 DTI 示踪成像的患者。

方法

对 2012 年 3 月至 2015 年 4 月期间接受 DTI 示踪术以手术切除 VS 的患者的病历进行了回顾。将此测量方法与手术医生确定的术中 FN 位置的可靠性进行了比较。House Brackmann（HB）评分用于评估面神经功能。

结果

共纳入 11 例患者，平均年龄为 43 岁（范围：19-64 岁），平均随访时间为 11.9 个月（范围：3.1-34.2 个月）。平均最大肿瘤直径为 2.82cm（范围：1.7-4.2cm）。DTI 示踪术在 90.9%（10/11）的患者中准确。术后，72.7%（8/11）的患者 HB 评分为 I 或 II，18.2%（2/11）的患者 HB 评分为 III，9.1%（1/11）的患者 HB 评分为 IV。