Presurgical visualization of the neurovascular relationship in trigeminal neuralgia with 3D modeling using free Slicer software

Objective To explore whether segmentation and 3D modeling are more accurate in the preoperative detection of the neurovascular relationship (NVR) in patients with trigeminal neuralgia (TN) compared to MRI fast imaging employing steady-state acquisition (FIESTA). Method Segmentation and 3D modeling u...

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Bibliographic Details
Published in:Acta neurochirurgica 2016-11, Vol.158 (11), p.2195-2201
Main Authors: Han, Kai-wei, Zhang, Dan-feng, Chen, Ji-gang, Hou, Li-jun
Format: Article
Language:English
Subjects:
Adult
Aged
Clinical Article - Neurosurgical Anatomy
Decompression, Surgical - methods
Female
Humans
Imaging, Three-Dimensional - methods
Interventional Radiology
Magnetic Resonance Imaging - methods
Male
Medicine
Medicine & Public Health
Middle Aged
Minimally Invasive Surgery
Neurology
Neuroradiology
Neurosurgery
Sensitivity and Specificity
Software
Surgical Orthopedics
Trigeminal Neuralgia - diagnostic imaging
Trigeminal Neuralgia - surgery
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Summary:Objective To explore whether segmentation and 3D modeling are more accurate in the preoperative detection of the neurovascular relationship (NVR) in patients with trigeminal neuralgia (TN) compared to MRI fast imaging employing steady-state acquisition (FIESTA). Method Segmentation and 3D modeling using 3D Slicer were conducted for 40 patients undergoing MRI FIESTA and microsurgical vascular decompression (MVD). The NVR, as well as the offending vessel determined by MRI FIESTA and 3D Slicer, was reviewed and compared with intraoperative manifestations using SPSS. Results The k agreement between the MRI FIESTA and operation in determining the NVR was 0.232 and that between the 3D modeling and operation was 0.6333. There was no significant difference between these two procedures (χ 2  = 8.09, P = 0.088). The k agreement between the MRI FIESTA and operation in determining the offending vessel was 0.373, and that between the 3D modeling and operation was 0.922. There were significant differences between two of them (χ 2  = 82.01, P = 0.000). The sensitivity and specificity for MRI FIESTA in determining the NVR were 87.2 % and 100 %, respectively, and for 3D modeling were both 100 %. Conclusion The segmentation and 3D modeling were more accurate than MRI FIESTA in preoperative verification of the NVR and offending vessel. This was consistent with surgical manifestations and was more helpful for the preoperative decision and surgical plan.
ISSN:0001-6268
0942-0940
DOI:10.1007/s00701-016-2936-8