术前MRI与Dyna-CTA三维影像融合对微血管减压术难易程度的评估价值

Value of preoperative MRI and Dyna-CTA 3D-imaging fusion to microvascular decompression

目的探讨术前MRI与Dyna-CTA三维影像融合对微血管减压手术难易程度的评估价值。方法将5例拟接受微血管减压术的患者术前行Dyna-CTA与MRI融合,了解责任血管的走向及其与绒球小结叶的相对关系,并对绒球小结叶凸起程度、后颅窝扁平程度等影响手术难易程度的参数进行测量评估,与显微镜下手术操作时间作比较。结果所有5例患者术中所见与融合后影像特征相符。责任血管与绒球小结叶的相对关系、术侧绒球小结叶凸起程度、后颅窝扁平程度是影响手术难易程度的重要因素。结论术前MRI与Dyna-CTA三维影像融合为微血管减压术的术前评估提供了一种安全有效的新方法,能够有效预测微血管减压术的难易程度。

ObjectiveTo investigate the value of preoperative MRI and Dyna-CTA three-dimensional（3D）-imaging fusion tomicrovascular decompression.MethodsMRI and Dyna-CTA 3D-imaging fusion was performed before the microvascular decompressionin 5 patients, of whom, 1 suffered from trigeminal neuralgia and 4 from facial hemispasm. The run of offending artery, the extent offlocculonodular lobe convexity, the posterior cranial fossa morphology were measured and the relationship between the offending arteryand floculonodular lobe was observed on the fused 3D-imaging in order to analyze their effects on operative proceeding.ResultsTheimportant morphological characteristics in operative field observed by the surgery were similar to those shown by the fused 3D-imaging.The perforating branch originated from the offending artery, the higher convexity of the flocculonodular lobe and high unevenness of theposterior cranial fossa prolonged the operative duration.ConclusionPreoperative 3D-imaging fusion of MRI and Dyna-CTA may behelpful to the preoperative assessment of the difficulty of microvascular decompression in the patients with trigeminal neuralgia or facialhemispasm.