探讨前交通动脉瘤相关动脉几何学形态对前交通动脉瘤破裂的风险预测价值

To explore the predictive value of anterior communicating aneurysm related arterial geometry to the risk of rupture

目的:利用CTA对双侧大脑前动脉及双侧颈内动脉的几何学参数进行分析,寻找前交通动脉瘤破裂的独立危险因素。方法:回顾性分析99例前交通动脉瘤,其中分为75例破裂组及24例未破裂组,利用CTA测量双侧大脑前动脉及双侧颈内动脉的几何学形态。使用统计学中单因素分析及多因素Logistic回归分析,对两组的临床资料及几何学形态进行分析。结果:通过单因素分析发现,在临床资料中,患者的年龄、性别、吸烟史以及高血压史的差异有显著性(P<0.05)。在几何学形态中,前交通动脉的长度以及双侧颈内动脉比值的差异有显著性(P<0.05)。通过多因素Logistic回归分析发现年龄≥60岁和双侧颈内动脉内径比值为0.7~<1.2与前交通动脉瘤破裂有显著相关性(P<0.05)。结论:年龄≥60岁和双侧颈内动脉内径比值为0.7~<1.2可成为前交通动脉瘤破裂的独立危险因素。

Objective:To analyze the geometric parameters of bilateral anterior cerebral arteries and bilateral internal carotid arteries to find independent risk factors for rupture of anterior communicating aneurysm based on CTA.Methods:A retrospective analysis of 99 cases of anterior communicating aneurysms,including 75 cases of ruptured group and 24 cases of unruptured group,using CTA to measure the geometric shape of bilateral anterior cerebral artery and bilateral internal carotid artery.Using single factor analysis and multivariate logistic regression analysis in statistics to make an analysis of the clinical data and geometric morphology of the two groups.Results:Through single factor analysis,it was found that the clinical data showed significant differences in the patients’age,gender,smoking history,and hypertension history(P<0.05).In the geometric form,there is also significant difference of the length of the anterior communicating artery and the ratio of bilateral internal carotid arteries(P<0.05).Through logistic multivariate regression analysis,it was found that the age≥60 and bilateral internal carotid artery diameter ratio of 0.7~<1.2 were significantly correlated with anterior communicating aneurysm rupture(P<0.05).Conclusion:Age≥60 and bilateral internal carotid artery diameter ratio of 0.7~<1.2 can be independent risk factors for rupture of anterior communicating aneurysm.