Department of Neurosurgery, Hebei General Hospital, Shijiazhuang, Hebei 050000, China.
Department of Neurosurgery, Hebei General Hospital, Shijiazhuang, Hebei 050000, China.
Clin Neurol Neurosurg. 2022 Jun;217:107241. doi: 10.1016/j.clineuro.2022.107241. Epub 2022 Apr 4.
To compare the diagnostic accuracy of 3D fast imaging employing steady-state acquisition (FIESTA) combined with 3D-time-of-flight (TOF) MR angiography (MRA) sequences (FTMS) and 3D-reconstuction synthesized by 3D-slicer program in evaluation the neurovascular relationships and offending vessels preoperatively in patients with hemifacial spasm (HFS).
Clinical data of HFS patients who underwent microsurgical vascular decompression (MVD) were analyzed. All patients underwent MRA scans with FTMS and 3D-reconstruction before surgery. The neurovascular relationship and offending vessels were evaluated and compared with intraoperative findings.
Forty patients were included in this study, 18 (45%) of them were male. The mean age was 49.6 years. The Kappa identity tests identified the agreement between the FTMS and intraoperative findings in evaluating the neurovascular relationship and offending vessel was 0.263 and 0.643, respectively. The agreement between the 3D-reconstruction and intraoperative findings was 0.633 and 0.921 respectively. There was borderline significant difference between the two methods in predicting neurovascular relationship (χ2 = 9.363, P = 0.053), and there were significant differences between the two methods in predicting offending vessels (χ2 = 188.408, P < 0.001). The sensitivity and specificity of FTMS in evaluating the neurovascular relationship were 89.7% and 100%, respectively, while those with 3D-reconstruction were both 100%. Moreover, the correct 3D- reconstruction examinations in predicting vessel and nerve relationships (r = 0.634, P = 0.034) and offending vessels (r = 0.652, P = 0.028) were significantly correlated with completely symptoms remission.
The 3D-reconstuction synthesized by 3D-slicer program was more accurate than FTMS in preoperative evaluation of neurovascular relationship and offending vessel. The technique is expected to be helpful in preoperative evaluation.
The dataset used and/or analyzed during the current study are available from the corresponding author on reasonable request.
比较三维快速稳态采集成像（FIESTA）联合三维时间飞跃（TOF）磁共振血管造影（MRA）序列（FTMS）与 3D-slicer 程序重建的三维重建（3D-reconstruction）在评估面肌痉挛（HFS）患者术前神经血管关系和责任血管方面的诊断准确性。
分析行微血管减压术（MVD）的 HFS 患者的临床资料。所有患者术前均行 FTMS 和 3D-reconstruction 行 MRA 扫描。评估神经血管关系和责任血管，并与术中发现进行比较。
本研究纳入 40 例患者，其中男性 18 例（45%），平均年龄 49.6 岁。Kappa 一致性检验结果显示，FTMS 评估神经血管关系和责任血管与术中发现的一致性分别为 0.263 和 0.643，3D-reconstruction 评估神经血管关系和责任血管与术中发现的一致性分别为 0.633 和 0.921。两种方法预测神经血管关系的一致性有边缘统计学差异（χ2=9.363，P=0.053），预测责任血管的一致性有统计学差异（χ2=188.408，P<0.001）。FTMS 评估神经血管关系的敏感度和特异度分别为 89.7%和 100%，3D-reconstruction 分别为 100%和 100%。此外，预测血管和神经关系（r=0.634，P=0.034）和责任血管（r=0.652，P=0.028）的准确 3D-reconstruction 检查与完全症状缓解显著相关。
3D-slicer 程序重建的三维重建在术前评估神经血管关系和责任血管方面比 FTMS 更准确。该技术有望有助于术前评估。
本研究中使用和/或分析的数据可根据合理要求向通讯作者索取。
