Application of 3D Slicer reconstruction technology in microvascular decompression for primary trigeminal neuralgia

Zhang Minghui; Yang Chenghao; Luo Fei; Deng Yunliang; Ding Hao

doi:10.11850/j.issn.1009-122X.2023.12.012

Abstract：Objective To investigate the application value of 3D Slicer reconstruction technology in microvascular decompression(MVD)surgery for primary trigeminal neuralgia(PTN).Methods A retrospective analysis was conducted on the medical records of 76 patients with PTN.Three-dimensional(3D)image reconstruction of major vessels,trigeminal nerve,facial nerve,cochlear nerve,and brainstem was performed preoperatively using 3D Slicer software.MVD was then performed,and the reconstructed images were compared and evaluated against intraoperative findings.Results Compared with intraoperative findings,the preoperative reconstructed images accurately identified the offending vessels in 94.7%(72/76)of cases.The Kappa test indicated a high degree of consistency between the two(Kappa coefficient=0.956,P<0.001).The accuracy of the reconstructed images in assessing the degree of nerve compression was 71.1%(54/76),with the Kappa test showing moderate consistency(Kappa coefficient=0.495).The chi-square test revealed a statistically significant difference in the degree of nerve compression between the reconstructed images and intraoperative findings(P<0.001),with the intraoperative findings indicating a higher degree of nerve compression than that depicted in the reconstructed images.Conclusion 3D Slicer reconstruction technology can clearly and accurately demonstrate the neurovascular relationships in PTN patients,essentially achieving preoperative visualization of neurovascular relationships during MVD,demonstrating its value in clinical application.However,the technology exhibits some limitations in depicting fine structural details.