颅内动脉瘤破裂风险和动脉瘤形态学参数的关系

目的 探讨颅内动脉瘤破裂风险相关的动脉瘤形态学参数。方法 回顾性分析114例颅内动脉瘤（61例未破裂动脉瘤，53例破裂动脉瘤）的临床资料，采用多因素Logistic回归分析检验7个动脉瘤形态学参数动脉瘤直径、动脉瘤高度与瘤颈宽度比值、动脉瘤高度与载瘤动脉直径比值（SR）、长宽比、入射角度、载瘤动脉角度和颈体角度）与动脉瘤破裂风险的关系。结果 动脉瘤长度越长，破裂风险越小（OR=0.470；95% CI 0.286~0.771；P=0.003）；SR越大，破裂风险越大（OR=18.998；95% CI 2.851~126.607；P=0.002）；颈体角度越大，破裂风险越大（OR=1.073；95% CI 1.023~1.125；P=0.004）。结论 SR、动脉瘤长度和颈体角度是判断颅内动脉瘤破裂风险的重要指标。

Relationship of rupture of intracranial aneurysm with its morphology

Objective To identify morphological parameters associated with intracranial aneurysms (IAs) rupture. Methods Seven morphological parameters were evaluated in 114 patients with saccular IAs (61 unruptured, 53 ruptured), including the ratio of aneurysmal diameter to parent artery diameter (size ratio, SR), ratio of aneurysmal height to parent artery height, ratio of aneurysmal height to aneurysmal neck width, ratio of aneurysmal height to width, angle between the parent artery longitudinal axis and aneurysmal diameter (incidence angle of blood flow) and angle between the plane where the aneurysmal neck was and the parent artery (aneurysmal inclination angle) and angle between the directions in which blood flew into and from the aneurysm (parent artery angle). The relationship of these factors with the aneurysm rupture was statistically analyzed. Results The multivariate Logistic regression analysis showed that small length of aneurysm (OR=0.470, 95% CI 0.286~0.771, P=0.003), high SR (OR=18.998, 95% CI 2.851~126.607, P=0.002) and big aneurysm inclination angle (OR=1.073, 95% CI 1.023~1.125, P=0.004) were independent risk factors related to the rupture of intracranial aneurysms. Conclusions It is suggested that the SR, aneurysmal inclination angle and length of aneurysms may be important factors related to the rupture of the intracranial aneurysms.