运用CTA分析颅内动脉瘤破裂的危险因素

发布时间：2018-06-22 18:44

  本文选题：颅内动脉瘤 + 形态学　； 参考：《临床放射学杂志》2017年01期

【摘要】：目的研究颅内动脉瘤(IA)形态学参数与其破裂风险的关系,初探CTA预测动脉瘤破裂的风险。方法搜集本院2014年6月至2015年4月经手术和CTA诊断为动脉瘤的110例患者(129个动脉瘤)。对于多发动脉瘤,依据CT平扫时蛛网膜下腔出血类型或者手术结果判定动脉瘤是否破裂,将其分为破裂组和未破裂组。动脉瘤形态学参数包括瘤颈宽度(N)、瘤体大小及形状、瘤体深度与瘤颈宽度的比值(AR)、瘤体深度与载瘤动脉直径的比值(SR)、瘤颈宽度与载瘤动脉直径的比值(NPR)、动脉瘤面积与瘤颈处载瘤动脉面积的比值。采用单变量和多变量Logistic回归分析计算动脉瘤破裂的独立危险因素。结果 110例IA患者,男29例,女81例,中位年龄(60.6±11.3)岁。IA前三位的好发位置是后交通动脉(46个)、大脑中动脉(30个)、大脑前动脉(26个)。破裂率前三位的位置是后交通动脉(38.6%)、大脑前动脉(25.0%)、大脑中动脉(22.7%)。单变量统计分析显示动脉瘤的大小、位置、AR、SR,面积比值和不规则的瘤壁在破裂组和未破裂组中具有显著差异。以动脉瘤的位置、不规则的瘤壁、性别和年龄作为调节变量,多变量分析显示动脉瘤大小≥3.85(AOR 2.913;95%CI 1.196~7.093),AR≥1.448(AOR 3.118;95%CI 1.230~7.903),SR≥1.388(AOR 5.245;95%CI 1.965~13.998)和面积比≥1.192(AOR 4.407;95%CI 1.569~12.379),是动脉瘤破裂的危险因素。结论大的动脉瘤及其面积比值,高的AR及SR值是独立于动脉瘤位置、瘤壁形态和患者性别、年龄的破裂危险因素。
[Abstract]:Objective to study the relationship between the morphological parameters of intracranial aneurysm (IA) and its risk of rupture. Methods 110 patients (129 aneurysms) diagnosed as aneurysms by CTA from June 2014 to April 2015 were collected. For multiple aneurysms, according to the type of subarachnoid hemorrhage during plain CT scan or the result of operation, the aneurysms were divided into ruptured group and unruptured group. The morphological parameters of the aneurysm include the width of the neck (N), the size and shape of the tumor. The ratio of tumor depth to neck width (AR), the ratio of tumor depth to the diameter of the aneurysm carrier artery (SR), the ratio of the width of the aneurysm to the diameter of the aneurysm carrier artery (NPR), and the ratio of the aneurysm area to the area of the aneurysm bearing artery at the neck of the aneurysm. Univariate and multivariate logistic regression analysis was used to calculate the independent risk factors of aneurysm rupture. Results among 110 patients with IA, 29 were males and 81 were females. The median age was (60.6 卤11.3) years old. The predilection locations of IA were posterior communicating artery (46), middle cerebral artery (30) and anterior cerebral artery (26). The first three sites of rupture rate were posterior communicating artery (38.6%), anterior cerebral artery (25.0%) and middle cerebral artery (22.7%). Univariate statistical analysis showed that the size, location, area ratio and irregular wall of aneurysms were significantly different between ruptured and unruptured groups. According to the location of aneurysm, irregular wall, sex and age, multivariate analysis showed that the size of aneurysm 鈮，

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