神经导航下射频治疗原发性三叉神经痛的解剖研究

The anatomical study of percutaneous radiofrequency thermocoagulation of the trigeminal ganglion under neuronavigation system

目的评估神经导航系统在射频治疗原发性三叉神经痛解剖参数测量的精确性。方法对25例(50侧)尸头标本行实际标本、CT影像及导航下分别测量卵圆孔的相关参数及不同手术入路穿刺针进针深度,评估3种测量方法的等效性及稳定性。结果实际标本测量,CT影像测量,导航测量卵圆孔长径分别为(8.42±1.38)mm,(8.46±1.34)mm,(8.50±1.42)mm。宽径分别为(4.57±0.88)mm,(4.62±0.88)mm,(4.63±0.95)mm。与实际标本测量数据相比,CT影像测量,导航测量卵圆孔参数均无统计学差异(P>0.2)。三种测量方法测得数据的变异系数结果显示影像测量组最小,实际测量组次之。实际测量组与导航组测得前入法穿刺深度分别为(64.26±8.09)mm,(64.72±8.29)mm。而侧入法穿刺深度则分别为(42.03±4.17)mm,(42.31±4.36)mm。二组差异无显著性(P>0.2)。两组测量数据的变异系数比较显示,导航测量组大于实际测量组。结论神经导航能精确测量卵圆孔各项径值及不同手术入路穿刺针进针深度。

Obieetive To evaluate the accuracy of the measurement of diameters about percutaneous radiofrequency thermocoagulation of the trigeminal ganglion under neuronavigation system. Methods The diameter of foramen ovale and the depth of needle in trigeminal ganglion blocking was measured with different surgery methods through neuronavigation system, CT images and standard scientific calipers, respectively. The equivalence and stability of the three measurement methods were evaluated. Results The average length of foramen ovale on basalis samples, CT images and neuronavigation system was （8.42±1.38）mm, （8.46±1.34） mm, （8.50±1.42）mm, and the average breadth was （4.57±0.88）mm, （4.62±0.88）mm, （4.63±0.95）mm accordingly. Compared with values on the cadavers, the values of other two measurement showed no statistic difference （P〉0.2）. The results of the coefficience of variation （CV） of the three groups showed that the values obtained through the CT image group was the smallest, next to which is the values obtained in cadavers. The distance from the anterolateral border of foramen ovale to the anterior puncturing point was （64.26±8.09）mm, （64.72±8.29）mm in cadavers and neuronavigation system, respectively; the distance from lateral border of foramen ovale to the lateral puncturing point was （42.03±4.17 ）mm, （42.31 ±4.36 ）mm respectively. The values of two groups showed no significant difference （/＇〉0.2）. The CV on the group of cadaver was slightly smaller than that of the group of neuronavigation. Conclusion The diameters of foramen ovale and the depth of needle in trigeminal ganglion blocking can be measured on neuronavigation system accurately. [K^worda] Neuronavigation; Oval foramen; Trigeminal neuralgia; Measurement