Cheng Runqi, Wang Tiansheng, Cai Yuankun, Chai Songshan, Shen Lei, Xu Dongyuan, Yang Jingyi, Yue Chuqiao, Pu Jianzhang, Xiong Nanxiang
Department of Neurosurgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, People's Republic of China.
Department of Neurosurgery, Beijing Shunyi District Hospital, Shunyi Teaching Hospital of Capital Medical University, Beijing, People's Republic of China.
J Pain Res. 2023 Aug 28;16:2929-2937. doi: 10.2147/JPR.S420283. eCollection 2023.
To predict the volume and shape of the balloon before PBC by reconstructing the Meckel's cave (MC) and establishing a volumetric measurement model, supporting preoperative preparation and intraoperative decisions.
The clinical data of 31 patients with good therapeutic effects who underwent PBC are retrospectively collected, including preoperative MRI, the volume of contrast agent injected into the balloon, and intraoperative lateral X-ray images. The MC on the affected side of the 31 patients is reconstructed based on MRI using 3D Slicer, while the volume of the MC is calculated to compare with the volume of contrast agent. The width (W) and length (L) of the model of the MC in lateral view are measured and used to classify the shape of the MC based on W/L. The consistency between the W/L of the model of the MC and the W/L of the intraoperative balloon is evaluated.
For volume, the mean value of the models of the MC (V) in 31 patients is 399.77±155.13 mm³, while the mean value of the contrast agent injected during PBC (V) is 539.03±111.93 mm³. The formula obtained by linear regression is V= 392.1 + 0.3676×V. Based on the value of W/L, the shape of the MC is classified into thin "pear" in 5 patients (16.13%), standard "pear" in 22 patients (70.97%), and square "pear" in 4 patients (12.90%). There is no significant difference in W/L between the models of the MC and the intraoperative balloons in 31 patients (P=0.221).
In 31 patients with good efficacy, it is verified that the prediction of the MC before PBC by 3D Slicer is consistent with the actual situation of the intraoperative balloon. This method can provide certain basis for preoperative preparation and intraoperative judgment.
通过重建Meckel腔(MC)并建立容积测量模型,预测经皮球囊压迫术(PBC)前球囊的容积和形状,为术前准备和术中决策提供支持。
回顾性收集31例接受PBC且治疗效果良好患者的临床资料,包括术前MRI、注入球囊的造影剂容积及术中侧位X线图像。利用3D Slicer基于MRI对31例患者患侧的MC进行重建,同时计算MC的容积并与造影剂容积进行比较。测量MC模型侧位视图的宽度(W)和长度(L),并根据W/L对MC的形状进行分类。评估MC模型的W/L与术中球囊的W/L之间的一致性。
容积方面,31例患者MC模型(V)的平均值为399.77±155.13mm³,而PBC期间注入造影剂的平均值(V)为539.03±111.93mm³。通过线性回归得到的公式为V = 392.1 + 0.3676×V。基于W/L值,MC的形状分为瘦“梨形”5例(16.13%)、标准“梨形”22例(70.97%)、方形“梨形”4例(12.90%)。31例患者MC模型与术中球囊的W/L之间无显著差异(P = 0.221)。
在31例疗效良好的患者中,验证了通过3D Slicer对PBC前MC的预测与术中球囊的实际情况相符。该方法可为术前准备和术中判断提供一定依据。