タイトル（掲載誌）Neurologia medico-chirurgica
一般注記type:Thesis
The preoperative assessment of cerebral veins is important to avoid unexpected cerebral venous infarction
in the neurosurgical setting. However, information is particularly limited regarding deep
Sylvian veins, which occasionally disturb surgical procedures for cerebral anterior circulation aneurysms.
The predictability of detecting deep Sylvian veins and their tributaries using a modern multimodal
fusion image was aimed to be evaluated. Moreover, 51 patients who underwent microsurgery
for unruptured cerebral aneurysms with Sylvian fissure dissection were retrospectively reviewed. The
visualization of the four components of the deep Sylvian veins in conventional computed tomography
(CT) venography and multimodal fusion images was evaluated. To compare the detection accuracy
among these radiological images, the sensitivity and specificity for the detection of each of the four
venous structures were calculated in comparison with those of intraoperative inspections. The kappa
coefficients were also measured and the inter-rater agreement for each venous structure in each radiological
image was examined. In all veins, the multimodal fusion image exhibited a high detection
rate without statistical difference from intraoperative inspections (P = 1.0). However, CT venography
exhibited a low detection rate with a significant difference from intraoperative inspections in the
common vertical trunk (P = 0.006) and attached vein (P = 0.008). The kappa coefficients of the fusion
image ranged from 0.73 to 0.91 and were superior to those of CT venography for all venous structures.
This is the first report to indicate the usefulness of a multimodal fusion image in evaluating deep
Sylvian veins, especially for the detection of nontypical, relatively small veins with large individual
variability.
博士（医学）・甲第864号・令和5年3月15日
Ⓒ 2022 The Japan Neurosurgical Society
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives International License.
identifier:Neurologia medico-chirurgica Vol.62 No.10 p.475-482 (2022 Oct)
identifier:04708105
identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4096
identifier:Neurologia medico-chirurgica, 62(10): 475-482
関連情報（DOI）10.2176/jns-nmc.2022-0206
連携機関・データベース国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）
提供元機関・データベース奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU