Nakae Shunsuke, Kumon Masanobu, Katagata Akio, Murayama Kazuhiro, Hirose Yuichi
Department of Neurosurgery, Fujita Health University, 1-98 Dengakugakubo Kutsukakecho, Toyoake 470-1192, Aichi, Japan.
Department of Radiology, Fujita Health University Hospital, 1-98 Dengakugakubo Kutsukakecho, Toyoake 470-1192, Aichi, Japan.
Brain Sci. 2023 Feb 25;13(3):396. doi: 10.3390/brainsci13030396.
Vagus nerve stimulation (VNS) is an effective surgical option for intractable epilepsy. Although the surgical procedure is not so complicated, vagus nerve detection is sometimes difficult due to its anatomical variations, which may lead to surgical manipulation-associated complications. Thus, this study aimed to visualize the vagus nerve location preoperatively by fused images of three-dimensional computed tomography angiography (3D-CTA) and magnetic resonance imaging (MRI). This technique was applied to two cases. The neck 3D-CTA and MRI were performed, and the fused images were generated using the software. The vagus nerve and its anatomical relationship with the internal jugular vein (IJV) and common carotid artery were clearly visualized. The authors predicted that the vagus nerve was detected by laterally pulling the IJV according to the images. Intraoperatively, the vagus nerve was located as the authors predicted. The time of the surgery until the vagus nerve detection was <60 min in both cases. This novel radiological technique for visualizing the vagus nerve is effective to quickly detect the vagus nerve, which has anatomical variations, during the VNS.
迷走神经刺激术（VNS）是治疗难治性癫痫的一种有效手术选择。尽管手术过程并不复杂，但由于迷走神经的解剖变异，有时难以检测到它，这可能会导致与手术操作相关的并发症。因此，本研究旨在通过三维计算机断层血管造影（3D-CTA）和磁共振成像（MRI）的融合图像在术前可视化迷走神经的位置。该技术应用于两例患者。进行了颈部3D-CTA和MRI检查，并使用软件生成融合图像。迷走神经及其与颈内静脉（IJV）和颈总动脉的解剖关系清晰可见。作者根据图像预测通过向外侧牵拉IJV来检测迷走神经。术中，迷走神经的位置与作者预测的一致。两例患者中检测到迷走神经的手术时间均<60分钟。这种用于可视化迷走神经的新型放射学技术对于在VNS期间快速检测具有解剖变异的迷走神经是有效的。
