颅内囊性动脉瘤破裂特征性因素回顾研究
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摘要
目的探讨颅内囊性动脉瘤破裂的危险因素。方法选取2015年3月至2017年2月间中山市小榄人民医院收诊的95例次87例囊性动脉瘤患者的临床资料和影像学资料进行回顾性分析,根据动脉瘤是否破裂分为未破裂组35例次和破裂组60例次。测量记录患者动脉瘤体长度和宽度、瘤体长度与宽度比值(L/W)、瘤颈宽度、瘤体长度/瘤颈宽度比值(AR)、瘤体宽度与瘤颈宽度比值(W/W)、子囊数、动脉瘤长径与载瘤动脉的夹角(入射角,IA)等。结果两组患者瘤体长度、瘤体宽度、瘤颈宽度和W/W度比值比较,差异无统计学意义(P> 0. 05),年龄、L/W、AR、子囊数和IA比较,差异均有统计学意义(均P <0. 05)。年龄、子囊和FA为颅内动脉瘤破裂的独立危险因素。结论年龄相对小、L/W值大、AR值大、存在子囊和IA大的动脉瘤相对容易破裂,年龄、子囊和入射角是独立危险因素。
Objective In order to investigate the risk factors for ruptured intracranial aneurysm.Methods Clinical data and morphological parameters of 95 patients with aneurysms treated at Xiaolan People's Hospital were collected and analyzed retrospectively from March 2015 to February 2017. Length and width of aneurysm,lenth/width ratio( L/W),neck width,aspectratio( AR),width/neck width ratio( W/W),perithecium number,the angle between the long trail and the width( inflow angle,IA). Results There was no significant differences in length and width of aneurysm and W/W between the two groups( P > 0. 05) whereas there was significant difference in age,gender,L/W,AR,perithecium number and IA between the two groups( all P < 0. 05). Conclusion Aneurysm patietns with relatively younger age,high L/W,high AR,and larger IA were more likely to rupture. Additionally,age,perithecium and IA were independent risk factors for aneurysms.
Objective In order to investigate the risk factors for ruptured intracranial aneurysm.Methods Clinical data and morphological parameters of 95 patients with aneurysms treated at Xiaolan People's Hospital were collected and analyzed retrospectively from March 2015 to February 2017. Length and width of aneurysm,lenth/width ratio( L/W),neck width,aspectratio( AR),width/neck width ratio( W/W),perithecium number,the angle between the long trail and the width( inflow angle,IA). Results There was no significant differences in length and width of aneurysm and W/W between the two groups( P > 0. 05) whereas there was significant difference in age,gender,L/W,AR,perithecium number and IA between the two groups( all P < 0. 05). Conclusion Aneurysm patietns with relatively younger age,high L/W,high AR,and larger IA were more likely to rupture. Additionally,age,perithecium and IA were independent risk factors for aneurysms.
引文
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[11] ZhengY,Xu F,Ren J,et al. Assessment of intracranial aneurysm rupture based on morphology parameters and anatomical locations[J]. NeuroIntervent Surg,2016,8:1240-1246.
[2] Heros RC,Zervas NT,Varsos V. Cerebral vasospasm after subarachnoid hemorrhage:an update.[J]. Annals Neurol,1983,14:599-608.
[3] Connolly ES Jr. International study of unruptured intracranial aneurysms[J]. J Neurosurg,2014,121:1022-1023.
[4] Wáng YXJ,Zhang L,Zhao L,et al. Elderly population have a decreased aneurysmal subarachnoid hemorrhage incidence rate than middle aged population:a descriptive analysis of 8 144 cases in mainland China[J]. Br J Neurosurg, 2018, 32:165-171.
[5] Wermer MJ,van der Schaaf IC,Algra A,et al. Risk of rupture of unruptured intracranial aneurysms inrelation to patient and aneurysm characteristics:an updated meta-analysis[J]. Stroke,2007,38:1404-1410.
[6] Sonobe M,Yamazaki T,Yonekura M,et al. Small unruptured intracranial aneurysm verification study:SUAVe study,Japan[J].Stroke,2010,41:1969-1977.
[7] Ujiie H,Tamano Y,sasaki K,et al. Is the aspectratio a reliable index for predicting the rupture of a saccular aneurysm?[J].Neurosurgery,2011,48:495-502.
[8] Dhar S,Tremmel M,Mocco J,et al. Morphology parameters for intracranial aneurysm rupture risk assessment[J]. Neurosurgery,2008,63:185-196.
[9] Ryu CW,Kwon OK,Koh JS,et al. Analysis of aneurysm rupture in relation to the geometric indices:aspect ratio,volume,and volume-to-neck ratio[J]. Neuroradiology,2011,53:883-889.
[10] Meng H,Tutino VM,Xiang J,et al. High WSS or low WSS?Complex interactions of hemodynamics with intracranial neurysm initiation,growth,and rupture:toward a unifying hypothesis[J]. Am J Neuroradiol,2014,35:1254-1262.
[11] ZhengY,Xu F,Ren J,et al. Assessment of intracranial aneurysm rupture based on morphology parameters and anatomical locations[J]. NeuroIntervent Surg,2016,8:1240-1246.