| Objective1. To probe the value of VR technology on observe the anatomy of intracranialsinus and variation.2. To reconstructe the relative virtual anatomical of para-intracranial-sinusmeningiomas by VR technology,and then simulate the surgery processing accordingto the observations on virtual anatomy. To probe the value of VR technology in thepreoperative evaluation of para-intracranial-sinus meningiomas according to theintraoperative findings.Material and Methods47patients with para-intracranial-sinus meningiomas and21patients withtrigeminal neuralgia or hemifacial spasm without intracranial venous system lesionswhom are collected from October2011to March2013.All the patients have to collect3D CE-MRV sequence and then some patients have to collect MPRAGE sequence.Then, the scan data are imported to Dextroscope imaging workstation, the anatomicstructures are rebuild. Observating the virtual anatomical of all patients,and thenpreoperating evaluation and simulating the surgery processing for the47para-intracranial-sinus meningiomas patients whom will be done surgical treatmentaccording to the observations on virtual anatomical to fully acess related surgicalinformation. The anatomy between the virtual findings and intraoperative findings andpostoperate review of3D CE-MRV were compared.Results1. The effect of reconstructing intracranial venous system、tumour tissue andbrain tissue with3D CE-MRV and MPRAGE sequences is well,the anatomicstructures can be observated comprehensive and at any angle in Dextroscope imagingworkstation.2. The direction of entering the SSS of BrV on both side of SSS mainly is retrograde,and concentrated in the middle、third1/3.The direction of antegrade andperpendicular of entering the SSS mainly concentrate in the first1/3.3. SSS enter TS by double branch method mainly and StS enter TS tiltedmainly,especially on the left.The most of the diameter and height of the TS was equal.4. The most shape of StS was linear, followed by column,while the GCV into thelumen of StS had no obvious change in general, followed by transverse diameter orlongitudinal diameter thining.5. The most shape of ISS was arcuation, followed was the type of no ISS and theaverage length of SSS was250.9mm.6. The existence of OS was higher, most of them was single type, located in thecentral of posterior fossa and into the end of StS gradullay.7.2cases remain sickle sinus were caused by TH area meningioma afterocclusion of StS, so the sickle sinus was an important drainage way and it should beprevent to be damaged during the operation.8. The accuracy of the VR technology was about97.9%for assessment therelationship among para-intracranial-sinus meningiomas, venous sinus and venousdrainage, the VR technology may reduce the operation risk and improve theprognosis as well.9. Of all the47patients with sinus meningioma, the SSS sewn pierced was9, theSSS cut sinus cavity tumor was8, the electric coagulation treatment of sinus wall was21，the sinus untreated was9, the rate of tumor all cut was about87.2%, the rate ofnerve dysfunction was48.9%.Long-term follow-up, the nerve dysfunction improvedwas95.7%.Conclusion1. The variability of intracranial sinus is large, the VR technology is the powerfultool for observing the intracranial sinus anatomy and has an important value ofassessing the intracranial sinus anatomy.2. With the improvement of the degree of sinus stenosis, a variety of collateralvenous circulation produce or strengthen gradually, especially for the superficialvenous anastomosis.3. The VR technology is accurate and intuitive for the preoperative evaluation ofthe relationship among para-intracranial-sinus meningiomas, sinus and venousdrainage, reducing the risk of surgery and postoperative complications as well as enhancing the tumor cutting rate and improving patients prognosis. |
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