64排CTA对前交通动脉复合体变异类型与前交通动脉瘤相关性研究

Variation of Anterior Communicating Artery Complex and the Risk of Anterior Communicating Aneurysms Development and Bleeding:A Correlation Study Using 64-Detector CT Angiography

目的利用64排螺旋CT血管成像(CTA),研究前交通动脉复合体变异类型与前交通动脉瘤(anteriorcommunicating aneurysms,ACoA)发病及破裂出血的相关性。资料与方法回顾性分析620例脑部CTA表现及临床资料,选取48例ACoA患者为研究组,121例无动脉瘤患者为对照组,分析A1段、前交通动脉影像表现及类型,比较ACoA发病、破裂出血与复合体变异、变异侧别的相关性。结果大脑前动脉A1段成窗畸形少见约3%,与ACoA发病无相关性。ACoA患者A1段变异发生率50%,对照组患者A1段变异发生率为31%,ACoA患者A1段变异发生率高于对照组,差异有显著统计学意义(χ2=5.12,P<0.05),存在明显左侧优势(χ2=7.79,P<0.01)。前交通动脉异常型发生率在ACoA患者中与对照组差异无统计学意义(χ2=0.72,P>0.05)。24例复合体变异的ACoA,动脉瘤破裂、蛛网膜下腔出血程度与复合体变异相关(Z=-2.63,P<0.05)。结论 CTA能清晰地显示前交通动脉复合体变异,前交通复合体变异与ACoA发病及破裂后出血严重程度相关。

Objective To study the variations of anterior communicating artery complex,and their relationship with anterior communicating aneurysms formation and bleeding using 64-detector CTA.Materials and Methods The cerebral CTA and clinical data of 620 cases were retrospectively analyzed.Among them,48 cases with ACoA as the study group,121 cases without aneurysms were collected as the control group.Results the rate of window malformation in A1 segment was about 3%,the difference has no statistically significant between ACoA group and the control group.The incidences of variation of the complex in ACoA and control group were 50% and 31%,and the difference has statistically significant（χ2=5.12,P0.05）,Left side superiority was found（χ2=7.79,P0.01）.Among 24 ACoA cases with variation of the complex,the subarachnoid hemorrhage was related to the variation of the complex（Z=-2.63,P0.05）.Conclusion CTA can virtually show the variation of anterior communicating artery complex.The variation is associated with aneurysm development and bleeding.