Establishment and clinical verification of a C-arm X-ray foramen ovale imaging method
Objective To establish a C-arm X-ray foramen ovale(FO)imaging method and conduct clinical verification.Methods The imaging data of patients(virtual imaging group,90 cases)who visited the outpatient clinic at the Department of Neurosurgery,the Second Affiliated Hospital of Zhengzhou University and received cranial thin-section CT scans from June 2020 to December 2022 were collected.Simulated imaging of the FO was made based on three-dimensional reconstruction of head CT images.Patients with primary trigeminal neuralgia who underwent percutaneous puncture and balloon compression of the semilunar ganglion of trigeminal nerve at the Department of Neurosurgery of the Second Affiliated Hospital of Zhengzhou University from January 2022 to June 2023 were prospectively enrolled into this study(real puncture group,12 cases).C-arm X-ray foramen ovale imaging was performed during the operation.The patient was placed in a supine position.Three points were marked:point A at the lower extreme of the nasal columella and points B and C at the intersection of the lateral margin of the orbit with an extension line of the zygomatic arch.The C-arm was rotated along a horizontal axis until points B,A,and C visually aligned.After confirming in fluoroscopy that point A essentially coincided with the line between the outermost of the bilateral infraorbital margins,the C-arm was rotated towards the puncture side in 20-25° for obtaining an image of FO.The imaging outcomes of the FO were divided into three categories:Ⅰ(complete and clear visualization),Ⅱ(partial visualization),and Ⅲ(slit-like visualization).The consistency of Class Ⅰ visualization of the FO under simulated X-ray fluoroscopy and CT images in the virtual imaging group was analyzed.The imaging result of the FO during surgery in the real puncture group was observed.Results Among the 90 patients in the virtual imaging group,75 had Class Ⅰ visualization of FO,8 had Class Ⅱ visualization,and 7 had Class Ⅲvisualization.Compared with CT images,the sensitivity of Class Ⅰ visualization of FO under simulated X-ray was 97.4％,and the specificity was 100％.The consistency test showed good consistency(Kappa=0.92,P＜0.001).During the percutaneous FO puncture in 12 patients,the FO were fully visualized and the FO puncture was successfully completed in all cases.Conclusion With the inclination angle determined through the specific projection of lower facial anatomical landmarks,the C-arm X-ray FO imaging method enables most patients to obtain good FO imaging results and can assist FO imaging during FO puncture.
万方数据
维普
