颅内动脉瘤形态参数同破裂风险相关性的对比研究

Correlation between aneurysm morphology and rupture risk

目的本研究旨在评估颅内动脉瘤的几何形态参数与其破裂风险之间的关系,以筛选出关键的动脉瘤破裂风险预测因子。方法回顾性研究2009年3月至2011年4月西安交通大学第一附属院神经外科收治的44例颅内动脉瘤病例,共52枚侧壁动脉瘤,其中36枚破裂动脉瘤,16枚未破裂动脉瘤。采用三维头颅CTA获得动脉瘤三维影像,测定动脉瘤大小及纵横比等二维形态参数及动脉瘤入射夹角等三维形态参数。运用t检验、卡方检验及Pearson相关进行数据分析。结果破裂动脉瘤组与未破裂动脉瘤组相比,入射夹角、动脉瘤长径和瘤高具有明显统计学差异(P<0.05)。破裂组动脉瘤的入射夹角明显大于未破裂组。同样,破裂组动脉瘤较未破裂组具有更长的瘤长径和瘤高。Pearson相关分析示动脉瘤入射夹角与动脉瘤破裂风险最为相关。结论动脉瘤入射夹角与动脉瘤破裂风险密切相关,可作为预测颅内未破裂动脉瘤破裂风险的重要评估因子之一。

Objective To assess the correlation between parameters of aneurysm morphology and rupture risk, so as to screen out the robust parameter of rupture risk for intracranial aneurysm （IA）.Methods Forty-four consecutive patients with 52 sidewall saccular IAs （36 ruptured, 16 unruptured） were investigated retrospectively. Several parameters representing aneurysm morphology were chosen to evaluate the rupture status of IA. Measurements were obtained from the CT angiography using the commercial software. The two dimensional parameters such as aneurysm size and aspect ratio along with the three dimensional parameters like aneurysm inflow angle and volume to ostium area ratio were also measured. These parameters were analyzed by two tailed independent sample t test, Chi-square test and Pearson correlation test.Results Inflow angle, aneurysm height and maximal dome dimension （Dmax） showed statistically significant differences between mean values in ruptured and unruptured group. Inflow angle in ruptured group was more obtuse than that in unruptured group. Height and Dmax of ruptured IAs were longer compared with those of unruptured IAs. Pearson correlation analysis showed that the inflow angle was more closely related with ruptured IAs than other parameters.ConclusionInflow angle is independently related with ruptured IAs which can be a better indicator for the rupture risk.