|Diffusion tractography of facial nerve in cerebello-pontine angle tumours|
Introduction. Preoperative imaging of the facial nerve (FN)
in relation to cerebello-pontine angle (CPA) tumour would
allow the surgeon to increase the safety of tumour resection.
Tractography based on diffusion tensor imaging (DTI) is a novel
method for visualisation of the white matter fibres and the
Aim. To evaluate the correspondence of preoperative DTI
with real FN position and assess the impact of FN imaging on
reduction of facial paresis rate.
Material and methods. In 2013-2014, DTI with 3D modelling
of CPA tumor was performed in 7 patients in the Neurosurgery
Department of the Medical University of Gdańsk. Various
factors were analysed, including age, gender, tumour size, its
histopathology, and FN real and DTI location.
Results. Postoperative facial paresis was diagnosed in 3 patients
(42.9%). In one patient, an eigenvector error of DTI occurred.
The real position of FN corresponded with DTI only in 57%
of patients. The sensitivity of 80% (95%CI:28.8-96.7%) was
achieved. None of examined factors was significantly related to
the agreement of the DTI with the real FN position. The correct
prediction of FN location by means of DTI did not influence the
reduction of postoperative facial paresis.
Conclusions. Contrary to some previous reports, sensitivity
of DTI in CPA tumours has been found to be low in our study.
Further prospective studies involving a greater number of
subjects are required to establish a firm position of DTI in FN
keywords: kąt mostowo-móżdżkowy, nerwiak nerwu słuchowego, nerwiak osłonkowy, neuroobrazowanie, dyfuzja rezonansu magnetycznego, traktografia, nerw twarzowy, cerebello-pontine angle, acoustic neuroma, vestibular schwannoma, neuroimaging, diffusion magnetic resonanc
pages: from 42 to 50
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