颅内动脉瘤形态学及血流动力学特征预测破裂风险的临床意义

Clinical significance of intracranial aneurysm morphology and hemodynamic changes in predicting rupture risk

目的探讨颅内动脉瘤形态学及血流动力学特征预测破裂风险的临床意义。方法选取嘉兴市第二医院2018年6月至2021年10月收治的24例颅内囊性动脉瘤患者为研究对象,比较颅内动脉瘤有、无破裂患者动脉瘤形态学参数[包括高宽比(AR)、动脉瘤高与载瘤动脉直径之比(SR)、入射角]及血流动力学参数[包括壁面剪应力(WSS)、振荡剪切因子(OSI)、相对滞留时间(RRT)]。结果颅内动脉瘤破裂出血11例,未破裂13例。破裂组患者AR、SR及入射角均明显高于未破裂组,差异均有统计学意义(均P<0.05);WSS明显低于未破裂组,而OSI、RRT均明显高于未破裂组,差异均有统计学意义(均P<0.05)。结论颅内动脉瘤形态学参数AR、SR、入射角结合血流动力学参数WSS、OSI、RRT有助于评估破裂风险。

Objective To explore clinical significance of intracranial aneurysm morphology and hemodynamic changes in predicting rupture risk.Methods Twenty-four patients with intracranial saccular aneurysm admitted to Jiaxing Second Hospital from June 2018 to October 2021 were selected.Morphological parameters of aneurysms[including aspect ratio(AR),size ratio(SR),incidence angle]and hemodynamic parameters[including wall shear stress(WSS),oscillation shear index(OSI),relative retention time(RRT)]of patients with and without ruptured intracranial aneurysms were compared.Results Intracranial aneurysm ruptured and hemorrhaged in 11 cases and unruptured in13 cases.AR,SR and incident angle in ruptured group were significantly higher than those in unruptured group(all P<0.05).WSS was significantly lower than that of the unruptured group,while OSI and RRT were significantly higher than that of the unruptured group(all P<0.05).Conclusion Morphological parameters AR,SR and incident angle combined with hemodynamic parameters WSS,OSI and RRT are helpful to evaluate the risk of rupture.