胚胎型大脑后动脉伴发颅内动脉瘤的多层螺旋CT血管造影分析

Evaluate fetal origin of posterior cerebral artery accompanied with intracranial aneurysm by CT angiography

目的:采用多层螺旋CT血管造影(CTA)分析胚胎型大脑后动脉(FTP)伴发颅内动脉瘤情况,探讨FTP是否为颅内动脉瘤危险因素。同时对比分析FTP伴发颅内动脉瘤与FTP未伴发颅内动脉瘤的相关临床资料。方法:3名医师复习155例头颅CTA的横断面、多平面重组(MPR)、容积再现(VR)图像,观察FTP是否存在及其分型,同时分析FTP患者与非FTP患者伴发颅内动脉瘤的部位、大小,是否存在蛛网膜下腔出血。电话回访FTP患者是否存在吸烟、高血压、冠心病和糖尿病病史。总结FTP发生率,采用χ2检验分析是否存在性别差异。分别总结FTP与非FTP患者伴发颅内动脉瘤的发生率。采用Fisher确切概率法比较FTP与非FTP患者伴发颅内动脉瘤的发生率,以及伴发颅内动脉瘤的FTP与未伴发颅内动脉瘤的FTP患者在年龄、性别、吸烟史、高血压、冠心病和糖尿病方面是否存在统计学差异。采用二项Logistic回归分析FTP是否为颅内动脉瘤危险因素。结果:FTP总体发生率为16.13%(25/155),男性为12.12%(12/99),女性为23.21%(13/56),其发生率无性别差异(P=0.071)。FTP患者伴发颅内动脉瘤的发生率为20%(5/25),全部为女性,非FTP患者伴发颅内动脉瘤的发生率为6.15%(8/135),FTP与非FTP在伴发颅内动脉瘤的发生率上存在统计学差异(P=0.038)。FTP是颅内动脉瘤发生的危险因素(P=0.031)。伴发颅内动脉瘤FTP患者与未伴发颅内动脉瘤FTP患者在性别、高血压、冠心病及糖尿病方面存在统计学差异(P<0.05),在年龄和吸烟史上不存在统计学差异(P>0.05)。结论:女性FTP患者在同时存在高血压、冠心病或糖尿病病史时,其伴发颅内动脉瘤的发生率明显增高。

Objective： To observe fetal origin of posterior cerebral artery （FTP） accompanied with intracranial aneurysm by CT angiography （CTA）. To investigate whether FTP is the risk factor of intracranial aneurysm. To analyze clinical datas（includ- ing age, gender, smoking history, hypertension, coronary heart disease and diabetes） of FTP patients whether accompanied with intracranial aneurysm. Methods： Three doctors reviewed intracranial CTA of 155 consecutive patients. Whether the FTP exist- ed or not was observed firstly. Then, FTP type and intracranial aneurysms accompanied with ~FP were observed carefully, in- cluding aneurysms＇ location, size, and subarachnoid hemorrhage. The clinical data including smoking history, hypertension, coronary heart disease and diabetes of patients with FTP were interviewed by telephone. The incidence of FTP, intracranial a- neurysms accompanied with FTP and non-FTP were calculated respectively. Gender difference about FTP was analyzed by X2 test. The incidence of intracranial aneurysms（including accompanied with FTP and non-FTP） and their clinical data were ana- lyzed by Fisher＇s exact test. Binary logistic regression analysis was used to evaluate weather FTP is the risk factor of in- tracranial aneurysm. Results： The FTP incidence was 16.13%（25/155） in overall, 12.12%（12/99） in male, 23.21%（13/56） in fe- male. There was no gender difference in FTP incidence （P=0.071）. The incidence of intracranial aneurysms accompanied with FTP and non-FTP was 20%（5/25）, 6.15%（8/135）, respectively. There was statistical difference in the incidence of intracranial aneurysms between FTP and non-FTP（P=0.038）. FTP is the risk factor of intracranial aneurysm（P=0.031）. There were statistical differences between intracranial aneurysms accompanied with FI＇P and non-FTP on gender, hypertension, coronary heart dis- ease and diabetes （P〈0.05）. On the contrary, there were no statistical difference between above on age and smoking （P〉0.05）. Conclusions： The incidence of intracranial aneurysms about female patients with FTP is significantly higher when they suf- fered hypertension, coronary heart disease or diabetes.