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已发表论文
一种卵圆孔移动C形臂透视成像新方法及其解剖学原理
Authors Qiu T, Guo Q, Kong T, Yin M, Bai Q , Zhang M, Wang G, Tao S, Liu Z
Received 21 August 2025
Accepted for publication 8 January 2026
Published 21 January 2026 Volume 2026:19 557040
DOI https://doi.org/10.2147/JPR.S557040
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Alaa Abd-Elsayed
Ting Qiu,1,* Qiancheng Guo,1,* Tengxiao Kong,1 Menglei Yin,1 Qian Bai,2 Mengdi Zhang,3 Genwei Wang,1 Shengzhong Tao,1 Zhan Liu1
1Department of Neurosurgery, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 2Department of Anesthesiology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 3Department of Medical Imaging, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhan Liu, Department of Neurosurgery, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China, Tel +86 0371 63620615, Email tomliuz2009@gmail.com
Purpose: Accurate localization of the foramen ovale (FO) is essential for percutaneous balloon compression, radiofrequency thermocoagulation, and glycerol injection in the treatment of trigeminal neuralgia. The mobile C-arm X-ray system is widely used due to its accessibility and low radiation exposure, but achieving optimal positioning to visualize the FO remains challenging. We propose a novel approach using facial surface landmarks to guide rapid and accurate C-arm positioning for FO fluoroscopy.
Patients and Methods: Patients were placed in the supine position, and three anatomical reference points were identified: Point A (subnasale), marked with a metal marker, and Points B and C (the intersections of the lateral orbital margins and the superior extensions of the zygomatic arches bilaterally), marked with surgical ink. With the X-ray tube of the C-arm centered above the face, the device was rotated along the transverse axis toward the foot end until Points A, B, and C appeared collinear from the tube’s eye view. Fluoroscopy was then used to confirm alignment of Point A with the line connecting the outermost points of the bilateral infraorbital margins. Finally, the tube was tilted 20– 25° toward the puncture side along its curved rail to visualize the FO. This method was validated through virtual simulation, intraoperative fluoroscopy, and 3D anatomical modeling.
Results: Clear FO images were obtained without additional adjustment in 170 of 200 simulated cases (85.0%) and in 28 of 30 intraoperative cases (93.3%). Simulated imaging showed excellent agreement with the actual osseous FO (Kappa = 0.96, p < 0.001; sensitivity = 0.99; specificity = 1.00), and intraoperative imaging demonstrated perfect agreement with the simulation (Kappa = 1.00, p < 0.001).
Conclusion: This technique provides reliable and accurate FO visualization, with excellent agreement between simulated, osseous, and intraoperative imaging. By simplifying the fluoroscopic process, this approach reduces the number of X-ray exposures required, thereby decreasing patient radiation exposure and shortening procedural time.
Keywords: foramen ovale, fluoroscopy, mobile C-arm X-ray system, trigeminal neuralgia, balloon compression
1Department of Neurosurgery, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 2Department of Anesthesiology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China; 3Department of Medical Imaging, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Zhan Liu, Department of Neurosurgery, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People’s Republic of China, Tel +86 0371 63620615, Email tomliuz2009@gmail.com
Purpose: Accurate localization of the foramen ovale (FO) is essential for percutaneous balloon compression, radiofrequency thermocoagulation, and glycerol injection in the treatment of trigeminal neuralgia. The mobile C-arm X-ray system is widely used due to its accessibility and low radiation exposure, but achieving optimal positioning to visualize the FO remains challenging. We propose a novel approach using facial surface landmarks to guide rapid and accurate C-arm positioning for FO fluoroscopy.
Patients and Methods: Patients were placed in the supine position, and three anatomical reference points were identified: Point A (subnasale), marked with a metal marker, and Points B and C (the intersections of the lateral orbital margins and the superior extensions of the zygomatic arches bilaterally), marked with surgical ink. With the X-ray tube of the C-arm centered above the face, the device was rotated along the transverse axis toward the foot end until Points A, B, and C appeared collinear from the tube’s eye view. Fluoroscopy was then used to confirm alignment of Point A with the line connecting the outermost points of the bilateral infraorbital margins. Finally, the tube was tilted 20– 25° toward the puncture side along its curved rail to visualize the FO. This method was validated through virtual simulation, intraoperative fluoroscopy, and 3D anatomical modeling.
Results: Clear FO images were obtained without additional adjustment in 170 of 200 simulated cases (85.0%) and in 28 of 30 intraoperative cases (93.3%). Simulated imaging showed excellent agreement with the actual osseous FO (Kappa = 0.96, p < 0.001; sensitivity = 0.99; specificity = 1.00), and intraoperative imaging demonstrated perfect agreement with the simulation (Kappa = 1.00, p < 0.001).
Conclusion: This technique provides reliable and accurate FO visualization, with excellent agreement between simulated, osseous, and intraoperative imaging. By simplifying the fluoroscopic process, this approach reduces the number of X-ray exposures required, thereby decreasing patient radiation exposure and shortening procedural time.
Keywords: foramen ovale, fluoroscopy, mobile C-arm X-ray system, trigeminal neuralgia, balloon compression