Department of Neurosurgery, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
Pediatric Department, Triemli Hospital, Zurich, Switzerland.
Acta Neurochir (Wien). 2023 Dec;165(12):3853-3866. doi: 10.1007/s00701-023-05878-y. Epub 2023 Nov 24.
Neurovascular relationships in the posterior fossa are more frequently investigated due to the increasing availability of 3.0 Tesla MRI. For an assessment with 3D visualization, no systematic analyzes are available so far and the question arises as to whether 3.0 Tesla MRI should be given preference over 1.5 Tesla MRI.
In a prospective study, a series of 25 patients each underwent MRI investigations with 3D-CISS and 3D-TOF at 1.5 and 3.0 Tesla. For both field strengths separately, blood vessel information from the TOF data was fused into the CISS data after segmentation and registration. Four visualizations were created for each field strength, with and without optimization before and after fusion, which were evaluated with a rating system and verified with the intraoperative situation.
When only CISS data was used, nerves and vessels were better visualized at 1.5 Tesla. After fusion, flow and pulsation artifacts were reduced in both cases, missing vessel sections were supplemented at 3.0 Tesla and 3D visualization at 1.5 and 3.0 Tesla led to anatomically comparable results. By subsequent manual correction, the remaining artifacts were further eliminated, with the 3D visualization being significantly better at 3.0 Tesla, since the higher field strength led to sharper contours of small vessel and nerve structures.
3D visualizations at 1.5 Tesla are sufficiently detailed for planning microvascular decompression and can be used without restriction. Fusion further improves the quality of 3D visualization at 3.0 Tesla and enables an even more accurate delineation of cranial nerves and vessels.
由于 3.0T MRI 的广泛应用，人们越来越关注后颅窝的神经血管关系。为了进行 3D 可视化评估，目前还没有系统的分析，因此出现了这样的问题：3.0T MRI 是否应该优先于 1.5T MRI。
在一项前瞻性研究中，每组 25 例患者分别在 1.5T 和 3.0T 下进行了 3D-CISS 和 3D-TOF 的 MRI 检查。对于两种场强，分别在分割和配准后将 TOF 数据中的血管信息融合到 CISS 数据中。为每种场强创建了 4 种可视化图像，在融合前后分别进行了优化和非优化，使用评分系统进行评估，并与术中情况进行验证。
仅使用 CISS 数据时，1.5T 时神经和血管的显示更好。融合后，两种情况下的血流和搏动伪影都减少了，3.0T 补充了缺失的血管部分，1.5T 和 3.0T 的 3D 可视化导致了解剖上可比的结果。通过随后的手动校正，进一步消除了剩余的伪影，3.0T 的 3D 可视化明显更好，因为更高的场强导致了小血管和神经结构的轮廓更加清晰。
1.5T 的 3D 可视化对于计划微血管减压术已经足够详细，可以无限制地使用。融合进一步提高了 3.0T 三维可视化的质量，使颅神经和血管的描绘更加准确。
