3D-TOF And 3D-fiesta Image-based 3D Model And Virtual Reality Preoperative Diagnosis Value In Microvascular Decompression Of Hemifacial Spasm

Objective:To investigate the application value of 3D-TOF and 3D-FIESTA image-based virtual reality for preoperative diagnosis of MVD,the etiological diagnosis for neurovascular compression patients with hemifacial spasm(HFS)is observed by 3D reconstruction of brainstem,VII N and vessel from the 3.0 T magnetic resonance imaging 3D-FIESTA and 3D-TOF magnetic resonance angiography.Materials and MethodsThe image processing was independently performed,observed and analysed by2 doctors,a skilled neuroradiologist(reviewer 1)and a skilled neurosurgeon(reviewer2),blinded to the patients’clinical characteristics.Through 3D reconstruction and VR interactive performance of 3D-FIESTA and 3D-TOF MRA,2reviewers,respectively,observed the results of NVC,recorded the scores and vessels,which compress the REZ of VII N.Then,compare the results of 3D model and original image with the observation from operation.Result:120 cases of primary hemifacial spasm preoperative 3D reconstruction and VR interactive performance using MRI 3D FIESTA and 3D-TOF MRA demonstrate the positive vascular nerve compression with 95.1%(symptomatic side)and 17.8%(asymptomatic side).And there were significant differences between these two sides(X~2=217.16,P=0.000).Comparing with intraoperative surgical results,the sensitivity and specificity of the 3D multimodal preoperative diagnosis were97.4%(113/116)and 100%(3/3),false positive rate was 0%(0/1),false negative rate was 2.6%(3/116),the positive prediction value and negative predictive value were100%(113/113)and 50%(3/6).The K agreement and Youden index between former and later were 0.655(95%CI 0.292~1.02)and 0.97.Conclusion:The 3D reconstruction and VR interactive simulation of 3D-FIESTA and3D-TOF MRA are reliable and valuable in detecting NVC and in predicting the degree of VII N root compression.The VR image-based simulation was consistent with surgical manifestations and was more helpful for the surgeons to make the preoperative decision and surgical plan.