CTA影像下前交通动脉瘤A1段优势发生的侧别研究

Research on the trend of the side in A1 segment predomination of anterior communicating artery aneurysms by analyzing computed tomographic angiography results.

目的对前交通动脉瘤患者的CTA造影结果进行回顾，分析前交通动脉瘤A1段优势征在CTA影像中侧别发生的规律。方法收集笔者所在科室自1997～2006年收治的自发性蛛网膜下腔出血病例134例，每个病例均于入院1周内行CTA扫描，按照有无前交通动脉瘤分为两组：前交通动脉瘤组和前交通动脉瘤阴性对照组，两对照组按照A1优势的侧别分布统计病例数量，最后进行统计学分析得出结论。结果CTA提示，68例前交通动脉瘤患者中A1段优势征37例（54．4％），其中左侧优势征29例（78．4％），右侧优势征8例（21．6％），左侧的发生率约是右侧的3倍。A1对称31例（45．6％）。而动脉瘤阴性组出现优势征11（16．7％）例，其中左侧优势征5例（45．5％），右侧优势征6例（55．5％），两侧基本相等。A1对称55例（83．3％）。前交通动脉瘤组中，A1段优势发生在左侧明显高于右侧（P〈0．001），差别有高度统计学意义，而对照组中，两侧无明显差别。结论与DSA造影结果相似，通常A1优势侧的动脉即为动脉瘤发生的载瘤动脉，而优势发生于左侧的比例明显大于右侧。

Objective On the basis of the results of CTA angiography were retrospectively analyzed for the trend of the side in A1 segment predomination of anterior communicating artery aneurysm. Methods A total of 134 patients of SAH were collected for study from 1997 to 2006. Each case was scanned by computed tomographic angiography within one week after admission. According to whether the existence of anterior communicating artery aneurysm or not was divided into two groups ： anterior communicating artery aneurysm group and free of the anterior communicating artery aneurysm group to contrast. The cases which are symmetry of bilateral A1, A2 as the free of A1 segment predomination group. The two control groups,respectively,on the ratio of the number of cases, in accordance with the A1 segment predomination exist side of distribution, carry out statistical analysis and finally conclude from the result of statistical analysis. Results Computed tomographic angiography results showed that of the 68 cases of anterior communicating artery aneurysm, AI segment predo mlnation in patients with 37 eases（54.4% ） ,of which 29 cases on the left side （78.4%） ,8 cases on the right side （21.6% ）, the incidence of left to right side was about 3 times. A1 symmetry 31 eases（45.6% ）. 11 （ 16.7% ） cases appeared in the free of the anterior communicating artery aneurysm group, of which five cases on the left side（45.5% ） ,six cases on the right side（55.5% ） ,basically the same on both sides. AI symmetry 55 cases（83.3% ）. In the anterior communicating artery aneurysm group,A1 segment predo ruination occurred in the left side was significantly higher than the right side（P 〈 0. 001 ）, a highly statistically significant difference, while the control group, no significant difference between the two sides. Conclusion To anterior communicating artery aneurysm, A1 segment predomination exist as well as the DSA images. It is usually the artery with A1 segment predomination is parent artery and which occurs on the left side more than the right in the proportion.