Preoperative Visual Evaluation Of The Neurovascular Relationship In Hemifacial Spasm

Objective:To explore the feasibility and predictive value of applying 3D-slicer software to evaluate the neurovascular relationship in patients with hemifacial spasm based on multimodal image.Method:This study retrospectively analyzed 80 patients with hemifacial spasm who underwent MVD.All patients underwent head MRI(including 3D-FIESTA,3D-TOF MRA sequence) before surgery and three-dimensional model reconstruction based on multimodal image using 3D-slicer software.The independent observers who were blinded to the surgical results were then used to evaluate the neurovascular relationship using a three-dimensional model and multimodal MRI images,and the results of the evaluation were compared with the intraoperative findings.Finally,the data was analyzed by SPSS 22.0 statistical software.Results:The k agreement between the 3D-FIESTA combined with 3D-TOF MRA and intraoperative findings in evaluating the neurovascular relationship was 0.343,whlie that was 0.637 between the three-dimensional reconstruction and intraoperative findings.There was significant difference between the two methods(X~2=18.852,P=0.001).The sensitivity and specificity of the 3D-FIESTA combined with 3D-TOF MRA in evaluating the neurovascular relationship were 89.7% and 100% respectively,while the three-dimensional reconstruction were both 100%.The k agreement between the 3D-FIESTA combined with 3D-TOF MRA and intraoperative findings in predicting the offending vessel was 0.664,whlie that was 0.895 between the three-dimensional reconstruction and intraoperative findings.There was significant difference between the two methods(X~2=368.139,P=0.000).The k agreement between the 3D-FIESTA combined with 3D-TOF MRA and intraoperative findings in detecting the anatomical position of neurovascular conflict was 0.670,whlie that was 0.897 between the three-dimensional reconstruction and intraoperative findings.There was significant difference between the two methods(X~2=613.010,P=0.000).Conclusions:Applying 3D-slicer software proved to be reliable in evaluating the neurovascular relationship in patients with hemifacial spasm based on multimodal image.Compared with 3D-TOF MRA sequence combined with 3D-FIESTA sequence,it is more accurate and consistent with the intraoperative findings.It is more helpful for preoperative planning and guiding surgery.