CTA对大脑中动脉动脉瘤形态学研究

发布时间：2018-02-03 10:30

  本文关键词： CTA 大脑中动脉 动脉瘤　出处：《吉林大学》2013年硕士论文　论文类型：学位论文

【摘要】：研究背景： 尽管已有很多学者研究了颅内动脉瘤，，但是在动脉瘤破裂的危险因素间的多重相关性的研究仍然不多。近几十年来，许多研究者通过研究动脉瘤的形态学参数来预测动脉瘤破裂的风险，但是仍没有找到可以确切预测动脉瘤破裂风险的独立参数。从这些研究中，我们已经了解了很多关于动脉瘤的知识。在很多研究人员中，动脉瘤的形态被认为是一个潜在的颅内动脉瘤破裂的因素。本研究致力于研究已被多名学者定义的不同形态学参数对动脉瘤破裂风险的预测。本文中动脉瘤形态的多个参数都显示与动脉瘤的破裂风险有相关性。在很多已经被认为可能预测动脉瘤破裂风险的形态学参数中，结果显示这些形态学参数可以作为预测动脉瘤破裂风险的因素。本研究通过研究动脉瘤患者CTA图像，比较不同形态学参数在预测动脉瘤破裂风险上的差异及统计学意义。 研究目的： 通过CT血管造影（CTA）研究大脑中动脉(MCA)动脉瘤的形态学特征。 材料与方法： 本研究搜集2011年1月至2012年1月到吉林大学第一医院就诊的患者，共62例患者，其中26例患者中，发现27个未破裂动脉瘤，另外36例患者，发现36个破裂动脉瘤。其中11例患者为双侧大脑中动脉动脉瘤，其他患者为单发或多发动脉瘤。只有发生在大脑中动脉的动脉瘤计入统计，其他部位动脉瘤不计入统计。除囊状动脉瘤外，梭形与霉菌性动脉瘤不计入本研究。医院计算机系统PACS（图片存档和通信系统）记录了每个病人的医疗记录，包括既往病史、影像学检查、治疗过程及结果。该系统通过回顾性分析为我们提供有用的信息。本研究通过CTA工作站后处理获得动脉瘤的形态学参数，并统计分析动脉瘤形态参数对动脉瘤破裂风险评估的意义。 结果： 统计发现，动脉瘤的各种形态学参数在评价预测动脉瘤破裂风险上均有显著性差异。 1.动脉瘤尺寸比SR作为唯一一个预测动脉瘤破裂风险的独立指标，也是最重要的形态学参数（p0.001，AUC0.78）。 2.动脉瘤其他形态学参数也可以预测其破裂风险，如最大动脉瘤高度Hmax(p≤0.001, AUC0.78),、深度Hpr(p≤0.001, AUC0.77),、高宽比AR (p=0.002,AUC0.73)及动脉瘤体积(p≤0.001, AUC0.75)。然而，Logistic回归分析显示这些形态参数不能作为预测动脉瘤破裂的独立指标。 3.动脉瘤（包括破裂及未破裂动脉瘤）好发于女性，右侧多于左侧。动脉瘤患者年龄大多分布在51-60岁，未破裂动脉瘤平均年龄55.59岁，破裂动脉瘤平均年龄52.56岁。 结论： 基于动脉瘤多种形态学参数的研究，CTA是预测动脉瘤破裂风险的重要影像学方法。尺寸比SR是最重要且最有意义的一个形态学参数。
[Abstract]:Background: Although many scholars have studied intracranial aneurysms, the multiple correlation between the risk factors of aneurysm rupture has not been studied much in recent decades. Many researchers have studied the morphological parameters of aneurysms to predict the risk of aneurysm rupture, but no independent parameters have been found to predict the risk of aneurysm rupture. We've learned a lot about aneurysms. Among many researchers. The morphology of the aneurysm is considered to be a potential cause of intracranial aneurysm rupture. This study is devoted to the prediction of the risk of aneurysm rupture by different morphological parameters that have been defined by many scholars. Multiple parameters of the aneurysm are associated with the risk of rupture of the aneurysm. In many morphological parameters that have been suggested to predict the risk of rupture of the aneurysm. The results showed that these morphological parameters could be used as a predictor of the risk of aneurysm rupture. In this study, CTA images of aneurysms were studied. To compare the difference and statistical significance of different morphological parameters in predicting the risk of aneurysm rupture. Objectives of the study: The morphological characteristics of MCA aneurysms in middle cerebral artery were studied by CT angiography (CTAA). Materials and methods: This study collected 62 patients from January 2011 to January 2012 in the first Hospital of Jilin University, of which 27 unruptured aneurysms were found in 26 patients. 36 ruptured aneurysms were found in 36 patients, 11 of whom were bilateral middle cerebral artery aneurysms. Other patients are single or multiple aneurysms. Only aneurysms that occur in the middle cerebral artery are counted, but not elsewhere. Except for cystic aneurysms. Fusiform and mildew aneurysms were excluded from this study. The hospital computer system PACS (Picture Archiving and Communication system) recorded the medical records of each patient, including past medical history and imaging examinations. The system provides us with useful information through retrospective analysis. The morphological parameters of aneurysms were obtained by CTA workstation postprocessing. The significance of the morphological parameters of aneurysm to the risk of aneurysm rupture was analyzed statistically. Results: According to statistics, the morphological parameters of aneurysm were significantly different in predicting the risk of aneurysm rupture. 1. Aneurysm size ratio (SR), as the only independent index to predict the risk of aneurysm rupture, is also the most important morphological parameter (p 0.001 AUC 0.78). 2. Other morphological parameters of aneurysms can also predict the risk of rupture, such as maximum aneurysm height Hmax(p 鈮

本文编号：1487153