Preoperative Guiding Significance Of 3D Slicer Multimodal Reconstruction Technique In Parasinusoidal Meningioma

Objective:To compare 3D Slicer multimodal reconstruction technique with preoperative imaging examination in preoperative evaluation of parasagittal meningioma(PSM),and to study the guiding significance of 3D Slicer multimodal reconstruction technique in preoperative PSM.Methods:63 patients with PSM diagnosed by the Department of Neurosurgery of the 940th Hospital of the Joint Logistics support Force of the Chinese people’s Liberation Army from May 2018 to January 2023 were collected retrospectively.All patients were examined by CT,MRI,MRA and MRV before operation and confirmed as meningioma by operation and postoperative pathological results.The skull model,the volume of PSM,the occlusion degree of sagittal sinus and the establishment of collateral vein were drawn by 3D Slicer software according to the preoperative CT,MRI and MRA sequence images.The volume and supply artery of PSM were compared with those of MRI,MRA and intraoperative findings.At the same time,the occlusion degree of sagittal sinus and the establishment of collateral vein were compared with MRV and intraoperative findings.Finally,the guiding significance of 3D Slicer software multimodal reconstruction technique in preoperative diagnosis of parasinusoidal meningiomas was evaluated.Results:The differences of tumor volume between 3D Slicer multimodal reconstruction and MRI measurement before PSM were as follows:the first one was(11.02±4.06)m L&10.64±3.99cm~3(P>0.05),the middle one was(10.73±4.12)&(10.38±4.13)cm~3,and the last one was(11.07±4.86)m L&(10.74±4.77)cm~3(P>0.05).There was a good linear correlation between the results of the two methods,and the correlation coefficients of the first,middle and posterior 1 PMS were 0.996,0.997 and 0.999,respectively.There was no significant difference in the display of feeding artery between MRA and multimodal reconstruction,and the diagnostic accuracy was 100%.The sensitivity,specificity and diagnostic accuracy of preoperative MRV to show the degree of venous sinus obstruction were 91.6%,80.0%and 88.8%,respectively,while the sensitivity,specificity and diagnostic accuracy of preoperative 3D Slicer reconstruction were 97.8%,93.7%and 96.8%,respectively.The sensitivity,specificity and diagnostic accuracy of preoperative MRV for collateral drainage veins were 20.0%,81.8%and 53.4%,respectively,while the sensitivity,specificity and diagnostic accuracy of preoperative 3D Slicer reconstruction were 34.5%,94.1%and 66.7%,respectively.Conclusion:1.The volume of PSM measured by multimodal tumor reconstruction method was significantly correlated with that of MRI.There was no significant difference in PSM between multimodal reconstruction method and MRI method.2.Compared with MRA,there was no significant difference in the display of PSM feeding artery by multimodal reconstruction.Compared with MRV,multimodal reconstruction technique can better evaluate the degree of occlusion of adjacent venous sinus and the establishment of collateral draining veins in PSM.Therefore,multimodal reconstruction technique can be used as a supplement to traditional imaging diagnosis and has important guiding significance for preoperative diagnosis of PSM.