Value of Multimodal Image-Based Virtual Reality for the Diagnosis of Neurovascular
Compression in Patients with Trigeminal Neuralgia and Hemi-Facial Spasm
YAO Shujing, LI Fangye, ZHAO Yining, ZHANG Jiashu, LI Chong, ZHANG Zhizhong, ZHANG Jun, CHEN Xiaolei
Department of Neurosurgery, Chinese PLA General Hospital, Beijing 100853, China
Abstract：Objective To address the feasibility and predictive value of multimodal image-based virtual reality in preoperative
evaluation of neurovascular compression in patients with trigeminal neuralgia and hemi-facial spasm. Methods This study included
40 patients who underwent microvascular decompression for classic primary trigeminal neuralgia or hemi-facial spasm. All patients
underwent a preoperative 1.5 T MRI with plain and enhanced 3D T1-weighted magnetization prepared rapid acquisition gradient
echo (MPRAGE) sequence, T2-weighted 3D sampling perfection with application-optimized contrasts by using different flip angle
evolutions (3D-SPACE) sequence, and 3D time-of-flight (TOF) magnetic resonance angiography (MRA) sequence in combination.
Multimodal MRI images were then co-registered with open-source software 3D Slicer, followed by three-dimensional image
reconstruction to generate virtual reality images of possible neurovascular compression. Evaluation of neurovascular compression
was then performed according to the virtual reality model and compared with the intra-operative findings. Results Preoperative
MRI scan and virtual reality model reconstruction were successfully completed in all of the 40 cases. For predicting the existence
of neurovascular compression, multimodal image-based virtual reality sensitivity was 97.4% (38/39), and specificity was 100%
(1/1). The Kappa coefficient for predicting the offending vessel was 0.921 (95% confidence interval, 0.817~1.02), P=0.000<0.001.
Conclusion Multimodal image-based virtual reality is proved to be reliable in detecting neurovascular compression and the
offending vessel in patients with trigeminal neuralgia and hemi-facial spasm, which can provide some guide for the microvascular
decompression surgery.
姚书敬，李昉晔，赵艺宁，张家墅，李翀，张治中，张军，陈晓雷. 基于多模态神经影像的虚拟现实技术对三叉神经痛和面肌痉挛患者血管神经压迫的诊断价值[J]. 中国医疗设备, 2017, 32(12): 7-10.
YAO Shujing, LI Fangye, ZHAO Yining, ZHANG Jiashu, LI Chong, ZHANG Zhizhong, ZHANG Jun, CHEN Xiaolei. Value of Multimodal Image-Based Virtual Reality for the Diagnosis of Neurovascular
Compression in Patients with Trigeminal Neuralgia and Hemi-Facial Spasm. China Medical Devices, 2017, 32(12): 7-10.
