CTA分析大脑前动脉远端动脉瘤破裂的危险因素

CTA analysis of risk factors for rupture of distal anterior cerebral artery aneurysm

目的探讨CTA测量参数分析大脑前动脉远端动脉瘤(DACAA)破裂的危险因素。方法分析陕西省人民医院2015年1月至2021年12月收治的45例DACAA患者的临床资料及CTA图像,分别记为破裂组、未破裂组,测量动脉瘤形态学相关参数。行两组间比较,阳性结果使用二元Lgistic回归,分析动脉瘤破裂危险因素的形态学参数,并以受试者工作特征曲线评估其诊断效能。结果破裂组26例,未破裂组19例,两组间动脉瘤规则与否、瘤宽、血流入射角等动脉瘤形态参数差异有统计学意义(P<0.05)。Logistic回归分析显示动脉瘤形态规则与否和血流入射角是其破裂的独立危险因素。当血流入射角>112.7°,受试者工作特征曲线下面积为0.970,灵敏度为96.2%,特异度为94.7%。结论动脉瘤形态不规则对判断动脉瘤破裂有意义,血流入射角>112.7°是动脉瘤破裂的独立危险因素。

Objective To investigate the risk factors of rupture of distal anterior cerebral artery aneurysm(DACAA)by CTA measurement parameters.Methods The clinical data and CTA images of 45 patients diagnosed as DACAA in Shaanxi Provincial People’s Hospital from January 2015 to December 2021 were analyzed retrospectively,which were recorded as ruptured group and ruptured group,respectively,and the morphological parameters of aneurysm were measured.The two groups were compared,and the positive results were analyzed by binary Logistic regression.The morphological parameters of the risk factors of aneurysm rupture were analyzed,and the receiver operating characteristic curve was used to evaluate the diagnostic performance.Results The rupture group included 26 patients and unruptured group was 19.There was significant differences in morphological parameters such as aneurysm regularity,aneurysm width,and blood flow incident angle(P<0.05).Logistic regression analysis showed that the regularity of aneurysm morphology and the incidence angle of blood flow were independent risk factors.And when the blood flow incident angle was greater than 112.7°,the area under receiver operating characteristic curves was 0.970,the sensitivity was 96.2%,and the specificity was 94.7%.Conclusion The irregular shape of aneurysm can be meaningful for judging aneurysm rupture.The blood flow incidence angle>112.70 is an independent risk factor for aneurysm rupture.