颅内囊性动脉瘤几何特征与破裂风险的关系

目的 分析反映颅内囊性动脉瘤几何特征的相关指标与破裂风险的关系.方法 对473例颅内囊性动脉瘤患者资料进行回顾性研究,破裂组和非破裂组分别有426例和47例患者,测量瘤体长径,瘤颈宽度及计算瘤体长径和瘤颈宽度的比值(AR值),分析以上3项指标与破裂风险的关系.结果 破裂组平均瘤体长径为(5.9±3.0)min,平均瘤颈宽度为(3.0±1.2)mm,平均AR值为2.1±0.9;未破裂组平均瘤体长径为(8.0±4.2)mm,平均瘤颈宽度为(4.8±2.4)min,平均AR值为1.7±0.6,两组间3项指标差异均有统计学意义(P<0.01).结论 AR值不受动脉瘤分布部位影响,是代表动脉瘤内血流动力学的良好指标.动脉瘤破裂风险随着AR值的增高而增大,但目前没有一个明确AR值可用来界定动脉瘤破裂风险.

Relationship between characteristic geometry and risk of rupture in cerebral saccular aneurysm

Objective To explore the relationship between the characteristic geometry and the risk of rupture in cerebral saccular aneurysm. Methods The clinical features of 473 cerebral saccular aneurysm patients with complete materials of cerebral angiography, 426 with ruptured aneurysm and 47 with unruptured aneurysm, were analyzed retrospectively. The relation of depth, neck width, and aspect ratio (AR) of aneurysms to the risk of rupture were analyzed. Results The mean depth, neck width, and the AR of the patients with ruptured aneurysm were (5.9±3.0) mm, (3.0±1.2) mm, and (2.1±0.9), all significantly lower than those of the unruptured aneurysm patients [(8.0±4.2) mm, (4.8±2.4) mm, and (1.7±0.6) respectively, all P<0.01]. Condnsion AR is not correlated with the location of aneurysms, but reflects the geometrical and hemodynamic features of cerebral saccular aneurysms very well. High AR may be useful in predicting imminent aneurismal rupture. But by now, no definitive AR level is accepted in discriminating between unruptured and ruptured aneurysms.