关于CTA评价脑动脉瘤稳定性的临床分析

Clinical analysis of CTA in evaluating stability of cerebral aneurysms

目的通过颅内动脉瘤患者相关病史结合CTA测量动脉瘤形态参数,评估颅内动脉瘤稳定性,减小颅内动脉瘤破裂导致的致残率及死亡率。方法选择2015年10月—2018年3月本院收治的经CT及CTA检查患有脑动脉瘤患者64例作为研究对象,根据CT及CTA检查结果分为A组(动脉瘤破裂组,31例)和B组(动脉瘤未破裂组,33例)两组。分析比较两组患者的年龄性别,高血压病史,糖尿病史等情况,以及CTA测量的形态相关参数。结果年龄比较(P=0.0028<0.05)、高血压病史比较(P=0.0389<0.005)、动脉瘤体积比较(P=0.0402<0.05)、动脉瘤瘤体高度分级比较(P=0.0275<0.05),以上差异均有统计学意义。结论老年动脉瘤患者更容易破裂﹑出现蛛网膜下腔出血,高血压很可能是破裂的重要诱因,动脉瘤瘤体高度3~10 mm,及体积越大更容易破裂,年龄,高血压病史,及瘤体高度分级,动脉瘤体积可能是临床预测动脉瘤破裂的重要指标。

Objective To evaluate the stability of intracranial aneurysms and reduce the disability rate and mortality rate caused by intracranial aneurysm rupture by combining the relevant history of intracranial aneurysm patients with the measurement of aneurysm morphological parameters by CTA.Methods From October2015 to March 2018,the 64 cases of patients with cerebral aneurysms that were confirmed by CT and CTA examination were enrolled in the study,according to the examination results they were divided into group A( ruptured aneurysm group,n = 31) and group B( unruptured aneurysm group,n = 33). Age,gender,history of hypertension,history of diabetes and other conditions of the two groups were analyzed and compared,as well as morphological parameters measured by CTA.Results There were statistically significant difference in age( P = 0.0028,P< 0. 05),hypertension history( P = 0. 0389,P < 0. 005),aneurysm volume( P = 0. 0402,P < 0. 05),aneurysm height grading( P = 0.0275,P<0.05) between the two groups.Conclusions The aneurysms in elderly patients are more likely to rupture and complicated with subarachnoid hemorrhage;high blood pressure is likely to be the important cause of rupture;the height of aneurysmsbetween 3 and10 mm,and the greater the volume is more likely to rupture;age,history of hypertension,the grade of cerebral aneurysms,and aneurysm volume may be clinically important predictor of aneurysm rupture.