基于心电监控4D-CTA技术的颅内动脉瘤影像学特点研究

发布时间：2018-08-13 18:09

【摘要】：目的:通过心电监控4D-CTA技术在颅内动脉瘤检查中的应用,探讨与颅内动脉瘤破裂相关的危险因素。方法:收集2015年8月至2016年12月在延边医院影像科行头部心电监控4D-CTA检查的患者,分别记录患者的年龄、性别、有无高血压病史、有无吸烟史。根据是否蛛网膜下腔出血,分为破裂颅内动脉瘤(RIA)组与未破裂颅内动脉瘤(UIA)组。记录动脉瘤的位置、形状(无子囊/有子囊)、有无搏动点,搏动点出现的位置及时相;测量的动脉瘤影像学指标包括:瘤颈宽度、瘤高、瘤体深度、载瘤动脉直径、体积;计算得出瘤高与瘤颈宽度的比值(AR)、瘤体深度与载瘤动脉直径的比值(SR)。采用统计学软件SPSS 18.0对两组的临床资料及影像学数据进行分析,比较两组之间的差异,P0.05差异有统计学意义。结果:1.RIA组和UIA组患者的性别、年龄、吸烟史比较无统计学差异,高血压病史在两组之间比较有统计学差异(P0.05),高血压患者在破裂组所占比例为70.8%,在未破裂组所占比例为33.3%。2.RIA组和UIA组的瘤颈宽度、瘤高、瘤体深度、载瘤动脉直径、体积比较无统计学差异,而瘤高与瘤颈宽度的比值(AR)、瘤体深度与载瘤动脉直径的比值(SR)、形状、有无搏动点、位置比较有统计学差异(P0.05)。RIA组与UIA组AR的平均值分别为1.41 ±0.51、0.89±0.40;RIA组与UIA组SR的的平均值分别为2.01±0.93、1.28±0.45;RIA组与UIA组有子囊动脉瘤所占比例分别为45.8%、0%;RIA组与UIA组有搏动点的动脉瘤所占比例分别为83.3%、13.3%;RIA组位于大脑中动脉者最多,占28%,UIA组位于颈内动脉者最多,占41.7%。3.经过Logistic多因素分析,AR、搏动点为颅内动脉瘤破裂的独立危险因素。结论:心电监控4D-CTA既能观察颅内动脉瘤的形态学特点,又能观察瘤壁的动态变化情况,AR值越高、出现搏动点是预测动脉瘤破裂的高风险因素。
[Abstract]:Objective: to investigate the risk factors associated with intracranial aneurysm rupture by electrocardiographic monitoring (4D-CTA) in intracranial aneurysms. Methods: from August 2015 to December 2016, patients with head ECG monitoring 4D-CTA were collected from Aug 2015 to Dec 2016 in Yanbian Hospital. The patients' age, sex, history of hypertension and smoking were recorded. According to the subarachnoid hemorrhage, the patients were divided into two groups: (RIA) group with ruptured intracranial aneurysm and (UIA) group with unruptured intracranial aneurysm. The position and shape of the aneurysm (without or without oocyst / ovary) and the position of the pulsatile point were recorded in time. The imaging parameters of the aneurysm were as follows: the width of the neck, the height of the aneurysm, the depth of the tumor, the diameter and volume of the artery carrying the aneurysm; The ratio of tumor height and neck width to the ratio of (AR), tumor depth to the diameter of the aneurysm carrier artery, (SR). Was calculated. The statistical software SPSS 18.0 was used to analyze the clinical data and imaging data of the two groups, and the difference between the two groups was statistically significant. Results 1. There was no significant difference in sex, age, smoking history between RIA group and UIA group. There was significant difference in the history of hypertension between the two groups (P0.05). The proportion of hypertensive patients in ruptured group was 70.8, and in unruptured group was the width of neck, tumor height, tumor depth, diameter of aneurysm carrier artery in 33.3%.2.RIA group and UIA group. There was no significant difference in volume, but the ratio of tumor height to neck width, the ratio of (AR), tumor depth to the diameter of the artery carrying the tumor, (SR), shape, pulsatile point, The average value of AR between RIA group and UIA group was 1.41 卤0.51g 0.89 卤0.40ria group and UIA group respectively. The average value of SR was 2.01 卤0.93ria group and UIA group, respectively. The proportion of aneurysms with oocyst artery aneurysm in RIA group and UIA group was 45.80.10% and that in UIA group was higher than that in RIA group (P < 0.05). The mean value of AR between RIA group and UIA group was 1.41 卤0.51g 0.89 卤0.40. The mean value of SR in RIA group and UIA group was 2.01 卤0.93 卤0.45. The proportion of RIA was 83.3% and 13.3%, respectively. The RIA group was the most located in the middle cerebral artery. In the 28 th group, the most were located in the internal carotid artery, accounting for 41. 7%. 3. Logistic multivariate analysis showed that pulsatile point was an independent risk factor for rupture of intracranial aneurysm. Conclusion: ECG monitoring 4D-CTA can not only observe the morphological characteristics of intracranial aneurysms, but also observe the dynamic changes of the aneurysm wall. The higher the AR value is, the higher the incidence of pulsatile point is in predicting the rupture of the aneurysm.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743;R816.1

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