Image Study On The Size And Shape Of Meckel's Cave

Objective: To explore the changes of the size and shape of Meckel's Cave and its influence on the percutaneous puncture of trigeminal semilunar ganglion by foramen ovale,so as to further improve the surgical techniques and guide the clinical work.Methods:(1)We collect personal and 3.0T MRI data of 163 patients with primary trigeminal neuralgia and 40 healthy individuals from September 2017 to July 2018.We calculate the volume of Meckel's Cave and obtain the three-dimensional shape of Meckel's Cave through image post-processing software,and measure the length,width,height and trigeminal foramen height of Meckel's Cave.Degree and inclination angle of Meckel's Cave in axial,coronal and sagittal position.The three-dimensional morphology of Meckel's Cave was classified by comparing the ratio of trigeminal foramen height to Meckel's Cave height.(2)The intraoperative o-arm scan data of 163 patients undergoing PBC were collected.The pre-operative MRI and intraoperative CT data of the same patient were fused by the image post-processing software to display the shape and path of the saccule,measure the distance between the clivus and the trigeminal foramen,and compare with the length of Meckel's Cave.The width and height of Meckel's Cave corresponding to the inclination of saccule were collected simultaneously Degree.Summarize the research data,through spss22.0 statistical analysis software analysis results,the final conclusion.Results:(1)In the TN group,the average Meckel's Cave volume on the affected side was 330.06(248.98,404.70)mm3,and the average length,width,and height were(12.00 ± 2.75),(8.16 ± 1.53)and(9.39± 1.73)mm,respectively.The average axial,sagittal,and coronal Meckel's Cave angles were(31.86 ± 7.49)?,38.12 ± 7.96? and35.40(30.85,39.58)?,the height of trigeminal foramen was(3.39± 1.41)mm,respectively.The average MC volume on the contralateral side was 343.62(253.78,414.47)mm3,and the average length,width,and height were(12.16 ± 1.11),(8.23 ± 1.62)and(9.03± 1.38)mm,respectively.The average axial,sagittal,and coronal MC angles were(39.82 ± 7.87)°,(38.72 ± 8.77)? and 34.74(29.56,38.72)°,the height of the trigeminal foramen was(3.48 ± 1.55)mm,respectively.In the healthy group,the average Meckel's Cave volume was 311.83(217.33,437.84)mm3,and the average length,width,and height were(12.26 ± 1.05),(8.40 ± 1.05)and(9.24 ±1.43)mm,the height of the trigeminal foramen was(2.64 ± 0.48)mm respectively.The average axial,sagittal,and coronal angles were(32.25 ± 7.97)°,(38.32 ± 8.08)° and 36.40(32.90,41.60)°,respectively.The ratio between the height of the trigeminal foramen and the height of Meckel's Cave is about 1 / 3.According to the ratio and the boundary of Meckel's Cave,the three-dimensional shape of Meckel's Cave can be roughly divided into almond shape,narrow-long shape and comb shape.(2)In the case group,the distance between the ramp and the trigeminal foramen was(6.30±1.64)mm,When the width of Meckel's Cave is less than 8.16 mm and / or the height is less than 9.21 mm,theballoon may incline during the puncture of PBC.The inclination rate of the balloon was 66.9% on the o-arm positive film and60.1% on the lateral film.Conclusion:(1)There is no statistical difference in Meckel's Cave volume between patients with primary trigeminal neuralgia and healthy people;there is no correlation between Meckel's Cave volume and age,and there is no correlation between Meckel's Cave volume and gender;the length,width and height of Meckel's Cave in patients with primary trigeminal neuralgia,as well as the tilt angle of axial position and crown position are different from that of healthy people,and there is no difference in the tilt angle of sagittal position.There was no significant difference in the height of the trigeminal foramen between the affected side and the healthy side.The three-dimensional shape of Meckel's Cave can be roughly divided into almond shape,narrow-long shape and comb shape.(2)In PBC operation,the width and height of Meckel's Cave determine whether the balloon inclines on the positive and lateral films.When the width of Meckel's Cave is less than 8.16 mm and / or the height is less than9.21 mm,the balloon inclines during the puncture of PBC operation;the incline angle of the balloon on the lateral film is equivalent to the sagittal incline angle of Meckel's Cave;the incline line on the lateral film basically bisects Meckel's Cave.The distance between the mark at the end of sacculus and the clivus is about half of the length of Meckel's Cave.