{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T18:58:13Z","timestamp":1785869893201,"version":"3.56.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"2","license":[{"start":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T00:00:00Z","timestamp":1590537600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T00:00:00Z","timestamp":1590537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001652","name":"Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001652","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Neuroradiol"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Controversy exists on the association of arterial hypertension (HTN) and neurovascular compression (NVC) at the ventrolateral medulla (VLM). No standardized and reproducible technique has been introduced yet for detection of NVC in HTN. This study aimed to generate, analyze and compare different results of exact reproducible anatomical 3D-representations of the VLM in patients with HTN, based on magnetic resonance imaging (MRI).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A\u00a03T scanner provided MRI (T2-constructive interference in steady state (CISS) high resolution imaging and three-dimensional Time-of-flight (3D-TOF) angiography) from the posterior fossa of 44\u00a0patients with clinical treatment-resistant HTN. Image processing consists of segmentation of the CISS data, registration and fusion of the CISS and TOF data and visualization. For each patient two 3D-visualizations (before and after fusion) were obtained. The reproduction quality of the vessels, flow-related signal variability and pulsation artifacts were analyzed and compared, using a\u00a0ranking score.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Integrating vascular information from TOF into CISS data reduced artifacts in 3D-visualizations of exclusively processed CISS data. The quality of 3D-visualization of the vessels near the brain stem was significantly improved (<jats:italic>p<\/jats:italic>\u202f=\u20090.004). The results were reproducible and reliable. The quality of the 3D-presentations of neurovascular relationships at the VLM improved significantly (<jats:italic>p<\/jats:italic>\u202f&lt;\u20090.001).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The 3D-visualization of fused image data provides an excellent overview of the relationship between cranial nerves and vessels at the VLM and simplifies the detection of NVC in HTN. It provides a\u00a0powerful tool for future clinical and scientific research. Although microvascular decompression (MVD) in treatment resistant HTN is not a\u00a0standard procedure, it can be discussed in selected patients with intractable severe HTN.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00062-020-00916-z","type":"journal-article","created":{"date-parts":[[2020,5,27]],"date-time":"2020-05-27T22:02:34Z","timestamp":1590616954000},"page":"335-345","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["3D-Visualization of Neurovascular Compression at the Ventrolateral Medulla in Patients with Arterial Hypertension"],"prefix":"10.1007","volume":"31","author":[{"given":"Panagiota","family":"Manava","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Naraghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roland","family":"Schmieder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf","family":"Fahlbusch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnd","family":"Doerfler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael M.","family":"Lell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Buchfelder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Hastreiter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,5,27]]},"reference":[{"key":"916_CR1","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1097\/00000658-198503000-00023","volume":"201","author":"PJ Jannetta","year":"1985","unstructured":"Jannetta PJ, Segal R, Wolfson SK Jr. Neurogenic hypertension: etiology and surgical treatment. I. Observations in 53 patients. Ann Surg. 1985;201:391\u20138.","journal-title":"Ann Surg"},{"key":"916_CR2","doi-asserted-by":"publisher","first-page":"103","DOI":"10.3171\/jns.1992.77.1.0103","volume":"77","author":"R Naraghi","year":"1992","unstructured":"Naraghi\u00a0R, Gaab\u00a0MR, Walter\u00a0GF, Kleineberg\u00a0B. Arterial hypertension and neurovascular compression at the ventrolateral medulla. A comparative microanatomical and patholgical study. J\u00a0Neurosurg. 1992;77:103\u201312.","journal-title":"J Neurosurg"},{"key":"916_CR3","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1161\/01.HYP.37.1.176","volume":"37","author":"H Hohenbleicher","year":"2001","unstructured":"Hohenbleicher H, Schmitz SA, Koennecke HC, Offermann R, Offermann J, Zeytountchian H, Wolf KJ, Distler A, Sharma AM. Neurovascular contact of cranial nerve IX and X root-entry zone in hypertensive patients. Hypertension. 2001;37:176\u201381.","journal-title":"Hypertension"},{"key":"916_CR4","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/s002340050023","volume":"42","author":"DR Johnson","year":"2000","unstructured":"Johnson D, Coley SC, Brown J, Moseley IF. The role of MRI in screening for neurogenic hypertension. Neuroradiology. 2000;42:99\u2013103.","journal-title":"Neuroradiology"},{"key":"916_CR5","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1159\/000195696","volume":"31","author":"PVE Legrady","year":"2008","unstructured":"Legrady P, Voros E, Bajcsi D, Sonkodi S, Barzo P, Abraham G. Neurovascular pulsatile compression and neurosurgical decompression of the rostral ventrolateral medulla in medically resistant hypertensive patients. Kidney Blood Press Res. 2008;31:433\u20137.","journal-title":"Kidney Blood Press Res"},{"key":"916_CR6","doi-asserted-by":"publisher","first-page":"1466","DOI":"10.1016\/S0140-6736(94)90289-5","volume":"344","author":"R Naraghi","year":"1994","unstructured":"Naraghi R, Geiger H, Crnac J, Huk W, Fahlbusch R, Engels G, Luft FC. Posterior fossa neurovascular anomalies in essential hypertension. Lancet. 1994;344:1466\u201370.","journal-title":"Lancet"},{"key":"916_CR7","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.3171\/jns.2004.100.6.1025","volume":"100","author":"R Naraghi","year":"2004","unstructured":"Naraghi R, Hastreiter P, Tomandl B, Bonk A, Huk W, Fahlbusch R. Three dimensional visualization of neurovascular relationship in the posterior fossa\u2014technique and clinical application. J\u00a0Neurosurg. 2004;100:1025\u201335.","journal-title":"J Neurosurg"},{"key":"916_CR8","doi-asserted-by":"publisher","first-page":"1006","DOI":"10.3171\/jns.2002.96.6.1006","volume":"96","author":"SA Sagelitz","year":"2002","unstructured":"S\u00e4glitz SA, Gaab MR. Investigations using magnetic resonance imaging: is neurovascular compression present in patients with essential hypertension? J\u00a0Neurosurg. 2002;96:1006\u201312.","journal-title":"J Neurosurg"},{"key":"916_CR9","first-page":"476","volume":"22","author":"C Thuerl","year":"2001","unstructured":"Thuerl C, Rump LC, Otto M, Winterer JT, Schneider B, Funk L, Laubenberger J. Neurovascular contact of the brain stem in hypertensive and normotensive subjects: MR findings and clinical significance. AJNR Am J Neuroradiol. 2001;22:476\u201380.","journal-title":"AJNR Am J Neuroradiol"},{"key":"916_CR10","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1148\/radiol.2301021285","volume":"230","author":"J Zizka","year":"2004","unstructured":"Zizka J, Ceral J, Elias P, Tintera J, Klzo L, Solar M, Straka L. Vascular compression of rostral medulla oblongata: prospective MR imaging study in hypertensive and normotensive subjects. Radiology. 2004;230:65\u20139.","journal-title":"Radiology"},{"key":"916_CR11","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1111\/j.1365-2265.2011.04098.x","volume":"75","author":"DB Stobo","year":"2011","unstructured":"Stobo DB, Lindsay RS, Connell JM, Dunn L, Forbes KP. Initial experience of 3 Tesla versus conventional field strength magnetic resonance imaging of small functioning pituitary tumours. Clin Endocrinol (Oxf). 2011;75:673\u20137.","journal-title":"Clin Endocrinol (Oxf)"},{"key":"916_CR12","first-page":"168","volume":"25","author":"JS Ross","year":"2004","unstructured":"Ross\u00a0JS. The high-field-strength curmudgeon. AJNR Am J Neuroradiol. 2004;25:168\u20139.","journal-title":"AJNR Am J Neuroradiol"},{"issue":"5","key":"916_CR13","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1007\/s00701-009-0588-7","volume":"152","author":"PR Leal","year":"2010","unstructured":"Leal PR, Hermier M, Froment JC, Souza MA, Cristino-Filho G, Sindou M. Preoperative demonstration of the neurovascular compression characteristics with special emphasis on the degree of compression, using high-resolution magnetic resonance imaging: a\u00a0prospective study, with comparison to surgical findings, in 100 consecutive patients who underwent microvascular decompression for trigeminal neuralgia. Acta Neurochir (Wien). 2010;152:817\u201325.","journal-title":"Acta Neurochir (Wien)"},{"key":"916_CR14","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1080\/02688690701632807","volume":"22","author":"L Tanrikulu","year":"2008","unstructured":"Tanrikulu L, Hastreiter P, Richter G, Doerfler A, Naraghi R. Virtual neuroendoscopy: MRI-based three-dimensional visualization of the cranial nerves in the posterior cranial fossa. Br J Neurosurg. 2008;22:207\u201312.","journal-title":"Br J Neurosurg"},{"key":"916_CR15","volume-title":"3D-visualization and registration for neurovascular compression syndrome analysis","year":"2002","unstructured":"Hastreiter\u00a0P, Naraghi\u00a0R, Tomandl\u00a0B, Bauer\u00a0M, Fahlbusch\u00a0R, editors. 3D-visualization and registration for neurovascular compression syndrome analysis. MICCAI 02, (Proc of 5th Int Conf on Med Img Comput and Comp-Assis Interv). Heidelberg, Berlin, New York: Springer; 2002."},{"key":"916_CR16","doi-asserted-by":"publisher","first-page":"1251","DOI":"10.3174\/ajnr.A2974","volume":"33","author":"M Garcia","year":"2012","unstructured":"Garcia\u00a0M, Naraghi\u00a0R, Zumbrunn\u00a0T, R\u00f6sch\u00a0J, Hastreiter\u00a0P, D\u00f6rfler\u00a0A. High-resolution 3D-constructive interference in steady-state MR imaging and 3D time-of-flight MR angiography in neurovascular compression: a comparison between 3T and 1.5T. AJNR Am J Neuroradiol. 2012;33:1251\u20136.","journal-title":"AJNR Am J Neuroradiol"},{"key":"916_CR17","volume-title":"Registrierung und Visualisierung medizinischer Bilddaten unterschiedlicher Modalit\u00e4ten","author":"P Hastreiter","year":"1999","unstructured":"Hastreiter\u00a0P. Registrierung und Visualisierung medizinischer Bilddaten unterschiedlicher Modalit\u00e4ten. Erlangen: University of Erlangen-Nuremberg; 1999."},{"key":"916_CR18","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1097\/01.hjh.0000431740.32696.cc","volume":"31","author":"G Mancia","year":"2013","unstructured":"Mancia G, Fagard R, Narkiewicz K, Red\u00f3n J, Zanchetti A, B\u00f6hm M, Christiaens T, Cifkova R, De Backer G, Dominiczak A, Galderisi M, Grobbee DE, Jaarsma T, Kirchhof P, Kjeldsen SE, Laurent S, Manolis AJ, Nilsson PM, Ruilope LM, Schmieder RE, Sirnes PA, Sleight P, Viigimaa M, Waeber B, Zannad F; Task Force Members. 2013 ESH\/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J\u00a0Hypertens. 2013;31:1281\u2013357.","journal-title":"J Hypertens"},{"key":"916_CR19","doi-asserted-by":"publisher","first-page":"E113","DOI":"10.1148\/rg.333125148","volume":"33","author":"S Pandey","year":"2013","unstructured":"Pandey S, Hakky M, Kwak E, Jara H, Geyer CA, Erbay SH. Application of basic principles of physics to head and neck MR angiography: troubleshooting for artifacts. Radiographics. 2013;33:E113\u201323.","journal-title":"Radiographics"},{"key":"916_CR20","doi-asserted-by":"publisher","first-page":"1154","DOI":"10.3171\/JNS-07\/12\/1154","volume":"107","author":"R Naraghi","year":"2007","unstructured":"Naraghi R, Tanrikulu L, Troescher-Weber R, Bischoff B, Hecht M, Buchfelder M, Hastreiter P. Classification of neurovascular compression in typical hemifacial spasm: three-dimensional visualization of the facial and the vestibulocochlear nerves. J\u00a0Neurosurg. 2007;107:1154\u201363.","journal-title":"J Neurosurg"},{"key":"916_CR21","doi-asserted-by":"publisher","first-page":"189","DOI":"10.4103\/2152-7806.172534","volume":"6","author":"L Tanrikulu","year":"2015","unstructured":"Tanrikulu\u00a0L, Hastreiter\u00a0P, D\u00f6rfler\u00a0A, Buchfelder\u00a0M, Naraghi\u00a0R. Classification of neurovascular compression in glossopharyngeal neuralgia: three-dimensional visualization of the glossopharyngeal nerve. Surg Neurol Int. 2015;6:189.","journal-title":"Surg Neurol Int"},{"key":"916_CR22","series-title":"VCMB","first-page":"117","volume-title":"GPU Accelerated Normalized Mutual Information and B-Spline Transformation","author":"M Te\u00dfmann","year":"2008","unstructured":"Te\u00dfmann\u00a0M, Eisenacher\u00a0C, Enders\u00a0F, Stamminger\u00a0M, Hastreiter\u00a0P. GPU Accelerated Normalized Mutual Information and B\u2011Spline Transformation. VCMB. 2008. pp. 117\u201324."},{"key":"916_CR23","volume-title":"Modern strategies of image processing for neurovascular compression in arterial hypertension","author":"P Hastreiter","year":"2006","unstructured":"Hastreiter\u00a0P, Dodenhoeft\u00a0N, Troescher-Weber\u00a0R, Hastreiter\u00a0L, Buchfelder\u00a0M, Naraghi\u00a0R. Modern strategies of image processing for neurovascular compression in arterial hypertension. 16th European Meeting on Hypertension. 2006."},{"key":"916_CR24","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1016\/S0140-6736(97)11343-5","volume":"352","author":"H Geiger","year":"1998","unstructured":"Geiger\u00a0H, Naraghi\u00a0R, Schobel\u00a0HP, Frank\u00a0H, Sterzel\u00a0RB, Fahlbusch\u00a0R. Decrease of blood pressure by ventrolateral medullary decompression in essential hypertension. Lancet. 1998;352:446\u20139.","journal-title":"Lancet"},{"issue":"6","key":"916_CR25","doi-asserted-by":"publisher","first-page":"1405","DOI":"10.3171\/2014.12.JNS141775","volume":"123","author":"M Sindou","year":"2015","unstructured":"Sindou\u00a0M, Mahmoudi\u00a0M, Br\u00eenzeu\u00a0A. Hypertension of neurogenic origin: effect of microvascular decompression of the CN IX\u2011X root entry\/exit zone and ventrolateral medulla on blood pressure in a\u00a0prospective series of 48 patients with hemifacial spasm associated with essential hypertension. J\u00a0Neurosurg. 2015;123:1405\u201313.","journal-title":"J Neurosurg"},{"key":"916_CR26","doi-asserted-by":"publisher","first-page":"147","DOI":"10.3171\/2011.7.JNS101378","volume":"116","author":"HD Boogaarts","year":"2012","unstructured":"Boogaarts\u00a0HD, Menovsky\u00a0T, de Vries\u00a0J, Verbeek\u00a0AL, Lenders\u00a0JW, Grotenhuis\u00a0JA. Primary hypertension and neurovascular compression: a\u00a0meta-analysis of magnetic resonance imaging studies. JNS. 2012;116:147\u201356.","journal-title":"JNS"},{"key":"916_CR27","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1038\/sj.jhh.1002124","volume":"21","author":"J Ceral","year":"2007","unstructured":"Ceral J, Zizka J, Eli\u00e1s P, Solar M, Klzo L, Reissigov\u00e1 J. Neurovascular compression in essential hypertension: cause, consequence or unrelated finding? J\u00a0Hum Hypertens. 2007;21:179\u201381.","journal-title":"J Hum Hypertens"},{"key":"916_CR28","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1148\/radiographics.21.6.g01nv241561","volume":"21","author":"BF Tomandl","year":"2001","unstructured":"Tomandl BF, Hastreiter P, Rezk-Salama C, Engel K, Ertl T, Huk WJ, Naraghi R, Ganslandt O, Nimsky C, Eberhardt KE. Local and remote visualization techniques for interactive direct volume rendering in neuroradiology. Radiographics. 2001;21:1561\u201372.","journal-title":"Radiographics"},{"key":"916_CR29","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.3171\/JNS-07\/12\/1137","volume":"107","author":"L Tanrikulu","year":"2007","unstructured":"Tanrikulu\u00a0L, Hastreiter\u00a0P, Troescher-Weber\u00a0R, Buchfelder\u00a0M, Naraghi\u00a0R. Intraoperative three-dimensional visualization in microvascular decompression. J\u00a0Neurosurg. 2007;107:1137\u201343.","journal-title":"J Neurosurg"},{"key":"916_CR30","doi-asserted-by":"publisher","first-page":"1369","DOI":"10.1016\/S1076-6332(03)00505-1","volume":"10","author":"P Hastreiter","year":"2003","unstructured":"Hastreiter P, Naraghi R, Tomandl B, Bonk A, Fahlbusch R. Analysis and 3\u2011dimensional visualization of neurovascular compression syndromes. Acad Radiol. 2003;10:1369\u201379.","journal-title":"Acad Radiol"},{"key":"916_CR31","first-page":"956","volume":"51","author":"H Akimoto","year":"2002","unstructured":"Akimoto H, Nagaoka T, Nariai T, Takada Y, Ohno K, Yoshino N. Preoperative evaluation of neurovascular compression in patients with trigeminal neuralgia by use of three-dimensional reconstruction from two types of high-resolution magnetic resonance imaging. Neurosurgery. 2002;51:956\u201361.","journal-title":"Neurosurgery"},{"key":"916_CR32","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.3174\/ajnr.A4683","volume":"37","author":"S Haller","year":"2016","unstructured":"Haller S, Etienne L, K\u00f6vari E, Varoquaux AD, Urbach H, Becker M. Imaging of neurovascular compression syndromes: trigeminal neuralgia, hemifacial spasm, vestibular paroxysmia, and Glossopharyngeal neuralgia. AJNR Am J Neuroradiol. 2016;37:1384\u201392.","journal-title":"AJNR Am J Neuroradiol"}],"container-title":["Clinical Neuroradiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00062-020-00916-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00062-020-00916-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00062-020-00916-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,6,17]],"date-time":"2021-06-17T16:10:03Z","timestamp":1623946203000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00062-020-00916-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,27]]},"references-count":32,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2021,6]]}},"alternative-id":["916"],"URL":"https:\/\/doi.org\/10.1007\/s00062-020-00916-z","relation":{},"ISSN":["1869-1439","1869-1447"],"issn-type":[{"value":"1869-1439","type":"print"},{"value":"1869-1447","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,27]]},"assertion":[{"value":"5 February 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 May 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical guidelines"}},{"value":"P.\u00a0Manava, R.\u00a0Naraghi, R.\u00a0Schmieder, R.\u00a0Fahlbusch, A.\u00a0Doerfler, M.\u00a0Lell, M.\u00a0Buchfelder and P.\u00a0Hastreiter declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in studies involving human participants or on human tissue were in accordance with the ethical standards of the ethics committee of the University and with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standards"}}]}}