单发未破裂颅内动脉瘤的瘤壁强化与其形态学的相关性研究

Relationships Between Wall Enhancement and Morphology of Single Unruptured Intracranial Aneurysm

目的:探讨单发未破裂颅内动脉瘤(UIA)的瘤壁强化(AWE)与其形态学的相关性。方法:收集经我院CT血管成像(CTA)确诊的85例单发UIA患者,对比造影剂给药前、后的高分辨磁共振血管壁成像图像,根据动脉瘤壁是否强化,分为无强化组(n=38)及强化组(n=47)。在CTA上对动脉瘤进行定位、判断有无子囊及分叶,测量动脉瘤形态学参数,包括直径、瘤颈宽、纵横比(AR)、尺寸比(SR)。比较2组间各参数的差异,分析AWE与形态学的关系。结果:无强化组与强化组的分叶及子囊构成比、直径、AR值及SR值差异具有统计学意义(P<0.05)。在多因素logistic回归分析中内动脉瘤直径、AR值、分叶及子囊构成比为AWE的独立危险因素,直径的最佳截断值为6.76mm,AR值的最佳截断值为1.15。结论:颅内动脉瘤直径、AR值、分叶及子囊构成比为瘤壁强化的独立危险因素,AWE可能是颅内动脉瘤破裂风险的危险因素。

Purpose:To investigate the correlation between aneurysm wall enhancement(AWE)and morphology in single unruptured intracranial aneurysm(UIA).Methods:Eighty-five patients with single UIA diagnosed by CT angiography(CTA)in our hospital were collected,and were divided into non-enhancement group(n=38)and enhancement group(n=47)according to the high-resolution MR vessel wall imaging.The location of aneurysms,the presence of sacs and lobules,and the morphological parameters of aneurysms were measured on CTA,including diameter,neck width,aspect ratio(AR),and size ratio(SR).The differences of the parameters of single UIA between the two groups were compared,and the relationship between the wall enhancement of single unruptured intracranial aneurysm and its morphology was analyzed.Results:There were significant differences in the constituent ratio,diameter,AR value and SR value of lobules and sacs between the non-enhancement group and the enhancement group(P<0.05).In the multivariate logistic regression analysis,the diameter of intracranial aneurysm,AR value and the composition ratio of lobulation and sacs were independent risk factors for aneurysm wall enhancement.The optimal cut-off value of diameter was 6.76 mm,and the optimal cut-off value of AR value was 1.15.Conclusion:The diameter of intracranial aneurysm,AR value and the ratio of lobulation and asci are independent risk factors for intracranial aneurysm wall enhancement.Intracranial aneurysm wall enhancement may be a risk factor for intracranial aneurysm rupture.