大脑前动脉A1段血管构象、A1-A2夹角与前交通动脉瘤形成及破裂的相关性研究

Study on the Relationship between the A1 Segment of Anterior Cerebral Artery, A1-A2 Angle and the Formation and Rupture of Anterior Communicating Artery Aneurysm

目的探讨大脑前动脉A1段血管构象、A1-A2夹角与前交通动脉瘤形成及破裂的相关性。方法搜集88例前交通动脉瘤患者及164名脑血管正常者CTA图像,分析大脑前动脉A1段血管构象、A1-A2角与前交通动脉瘤形成的关系。前交通动脉瘤组按破裂与未破裂又分成两组,比较两组间大脑前动脉A1段血管构象、A1-A2角、瘤侧A1-A2角与动脉瘤破裂的关系。结果前交通动脉瘤组A1段血管构象以一侧优势型居多,正常对照组以均衡型居多,差异有统计学意义(P<0.05);前交通动脉瘤破裂与未破裂组的A1段血管构象比较无统计学意义(P>0.05)。前交通动脉瘤的A1-A2角小于正常对照组,前交通动脉瘤破裂组A1-A2角及瘤侧A1-A2角均小于未破裂组,差异有统计学意义(P<0.05)。结论大脑前动脉A1段血管构象与前交通动脉瘤形成相关,以一侧优势型更易好发,但不是动脉瘤破裂的影响因素;A1-A2夹角可以预测前交通动脉瘤的形成及破裂,较小的A1-A2夹角容易形成前交通动脉瘤,且更易破裂出血。

Objective To investigate the relationship between the vascular conformation of the A1 segment of the anterior cerebral artery, the angle between A1-A2 and the formation and rupture of the anterior communicating aneurysm. Methods CTA images of 88 patients with anterior communicating aneurysm and 164 patients with normal cerebral vessels were collected, and the relationship between the vascular conformation of the A1 segment of the anterior cerebral artery, A1-A2 angle and the formation of anterior communicating aneurysm was analyzed. The anterior communicating artery aneurysm group was divided into two groups according to ruptured and unruptured aneurysm. The relationship between the vascular conformation of the A1 segment of the anterior cerebral artery, the A1-A2 angle, the A1-A2 angle on the aneurysm side and the rupture of the aneurysm were compared between the two groups. Results The A1 vascular conformation of the anterior communicating aneurysm group was dominated by one side, and the normal control group was mostly equal on both sides. The difference was statistically significant(P<0.05). The comparison between the A1 vascular conformation of the ruptured and unruptured anterior communicating aneurysm groups was not statistically significant(P>0.05). The A1-A2 angles of the anterior communicating aneurysm were smaller than the normal control group. The A1-A2 angles and the A1-A2 angles of the ruptured anterior communicating aneurysm group were smaller than those of the unruptured group, and the difference was statistically significant(P<0.05). Conclusion The formation of ACoAA is related to the A1 segment of ACA,and the dominant A1 segment is more likely to develop aneurysm, but it is not related to its rupture.The angle of A1-A2 can predict the formation and rupture of ACoA. Thesmaller A1-A2 angle is more likely to form ACoAA and rupture.