Data fusion and 3D visualization for optimized representation of neurovascular relationships in the posterior fossa

Abstract

Background Reliable 3D visualization of neurovascular relationships in the posterior fossa at the surface of the brainstem is still critical due to artifacts of imaging. To assess neurovascular compression syndromes more reliably, a new approach of 3D visualization based on registration and fusion of high-resolution MR data is presented. Methods A total of 80 patients received MRI data with 3D-CISS and 3D-TOF at 3.0 Tesla. After registration and subsequent segmentation, the vascular information of the TOF data was fused into the CISS data. Two 3D visualizations were created for each patient, one before and one after fusion, which were verified with the intraoperative situation during microvascular decompression (MVD). The reproduction quality of vessels was evaluated with a rating system. Results In all cases, the presented approach compensated for typical limitations in the 3D visualization of neurovascular compression such as the partial or complete suppression of larger vessels, suppression of smaller vessels at the CSF margin, and artifacts from heart pulsation. In more than 95% of the cases of hemifacial spasm and glossopharyngeal neuralgia, accurate assessment of the compression was only possible after registration and fusion. In more than 50% of the cases with trigeminal neuralgia, the presented approach was crucial to finding the actually offending vessel. Conclusions 3D visualization of fused image data allows for a more complete representation of the vessel-nerve situation. The results from this approach are reproducible and the assessment of neurovascular compression is safer. It is a powerful tool for planning MVD.

A novel non-segmented inverted water outline rendering method can improve the tracking of responsible blood vessels for hemifacial spasm

“…Although some researchers have used multi-modal fusion technology to display the relationship between vessels and nerves ( Guo et al, 2012 ; Brinzeu et al, 2018 ; Hastreiter et al, 2022 ), this approach requires registration and increases the scanning time, among other limitations ( Donahue et al, 2017 ). Alternatively, certain researchers have employed flipped MRI image pixels and gray gradient rendering to enhance the accuracy of identifying responsible vessels ( Wang et al, 2020 ).…”

The Visualization of Intraneural Venous Compression in Trigeminal Neuralgia by Using Advanced Three-Dimensional Computer Graphics: An Illustrative Case Report

“…Thus, the advent of image fusion and 3D model reconstruction is expected to aid in overcoming these difficulties. Such methods for overcoming the limitations of MRI sequences can provide an overview of the spatial relationships of nerves and vessels, which can be observed from different perspectives, enabling a more accurate preoperative diagnosis of NVC [9][10][11][12][13], and ultimately improving detection of venous NVCs [8]. In this case, we used multimodal image fusion of MRI and multi-detector CT images with high spatial resolution, as previously described [14].…”