基于CTA的破裂与未破裂前交通动脉瘤形态学参数对比

发布时间：2018-05-13 13:46

本文选题：前交通动脉 + 动脉瘤　；参考：《中国医学影像技术》2016年07期

【摘要】：目的分析破裂与未破裂前交通动脉瘤的形态学特征,探讨影响前交通动脉瘤破裂的形态学因素。方法回顾性分析诊断为前交通动脉瘤的114例患者共114个前交通动脉瘤的资料,其中破裂组88个,未破裂组26个。记录CTA图像中动脉瘤的形状、长径、单发或多发、瘤颈宽度、瘤体宽度、纵横比(AR)、动脉瘤倾斜角及血流夹角、大脑前动脉A1段血管构象和动脉瘤指向,对以上因素进行单因素分析及Logistic回归分析。结果破裂组与未破裂组前交通动脉瘤单发/多发(P=0.001)、动脉瘤形状(P=0.002)、瘤颈宽度(P0.001)、长径(P0.001)、瘤体宽度(P0.001)、AR值(P=0.014)、血流夹角(P0.001)和单侧A1优势型发生率(P=0.023)差异均有统计学意义。Logistic回归分析中,瘤颈宽度(OR=2.950,P=0.022)、AR(OR=6.206,P=0.022)、血流夹角(OR=1.121,P0.001)是前交通动脉瘤破裂的独立危险因素,对其均具有正向影响;ROC曲线分析显示敏感度(76.1%)、特异度最大时(88.5%)对应血流夹角为126.65°。结论瘤颈宽度、AR值和血流夹角是前交通动脉瘤破裂的独立危险因素,瘤颈越宽、AR值越大、血流夹角越大前交通动脉瘤破裂风险越高,可将血流夹角=126.65°作为判断前交通动脉瘤破裂风险的临界值。
[Abstract]:Objective to analyze the morphological characteristics of ruptured and unruptured anterior communicating aneurysms and to explore the morphological factors affecting the rupture of anterior communicating aneurysms. Methods 114 patients with anterior communicating aneurysms were analyzed retrospectively, including 88 ruptured group and 26 unruptured group. The shape, length, diameter, single or multiple aneurysms, neck width, tumor width, aspect ratio, aneurysm tilt angle and blood flow angle, anterior cerebral artery A1 segment angioconformation and aneurysm orientation were recorded on CTA images. Single factor analysis and Logistic regression analysis were used to analyze the above factors. Results there were significant differences between ruptured group and unruptured group in single / multiple anterior communicating artery aneurysm (P0. 001), aneurysm shape (P0. 002), neck width (P0. 001), long diameter (P0. 001), tumor width (P0. 001), blood flow angle (P0. 001) and unilateral A 1 dominant type (P0. 023). The neck width of the anterior communicating artery was 2.950 ~ 2.950p ~ (0.022) ~ (6.206) and the blood flow angle was 1.121g / P _ 0.001). All of them had a positive effect on the rupture of the anterior communicating aneurysm. The sensitivity of the aneurysm was 76.1g, and when the specificity was the highest, 88.5% of the blood flow angle was 126.65 掳. Conclusion the AR value and the blood flow angle are independent risk factors for the rupture of anterior communicating artery aneurysm. The wider the aneurysm neck is, the greater the AR value is, and the greater the angle of blood flow is, the higher the risk of rupture of anterior communicating artery aneurysm is. The angle of blood flow is 126.65 掳as the critical value to judge the rupture risk of anterior communicating artery aneurysm.
【作者单位】：重庆医科大学附属第一医院放射科;
【基金】：国家临床重点专科建设项目(国卫办医函[2013]544号) 重庆市卫计委医学科研项目(2013-2-017)
【分类号】：R743;R816.1

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