一般注記type:Thesis
The preoperative assessment of cerebral veins is important to avoid unexpected cerebral venous infarctionin the neurosurgical setting. However, information is particularly limited regarding deepSylvian veins, which occasionally disturb surgical procedures for cerebral anterior circulation aneurysms.The predictability of detecting deep Sylvian veins and their tributaries using a modern multimodalfusion image was aimed to be evaluated. Moreover, 51 patients who underwent microsurgeryfor unruptured cerebral aneurysms with Sylvian fissure dissection were retrospectively reviewed. Thevisualization 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 accuracyamong these radiological images, the sensitivity and specificity for the detection of each of the fourvenous structures were calculated in comparison with those of intraoperative inspections. The kappacoefficients were also measured and the inter-rater agreement for each venous structure in each radiologicalimage was examined. In all veins, the multimodal fusion image exhibited a high detectionrate without statistical difference from intraoperative inspections (P = 1.0). However, CT venographyexhibited a low detection rate with a significant difference from intraoperative inspections in thecommon vertical trunk (P = 0.006) and attached vein (P = 0.008). The kappa coefficients of the fusionimage 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 deepSylvian veins, especially for the detection of nontypical, relatively small veins with large individualvariability.
博士（医学）・甲第864号・令和5年3月15日
Ⓒ 2022 The Japan Neurosurgical SocietyThis 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
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