垂直瘤体高度/瘤颈管径比值与动脉瘤破裂风险的相关性

目的：探讨前交通动脉（AComA）动脉瘤垂直瘤体高度与瘤颈管径的比值（AR）与动脉瘤破裂的关系。方法：回顾性分析2010年10月至2016年1月温州医科大学附属第一医院神经外科收治的650例AComA动脉瘤患者的动脉瘤形态参数，其中破裂动脉瘤578例，未破裂动脉瘤72例。分别收集2组动脉瘤的垂直瘤体高度及瘤颈管径，同时分析两者的比值AR值与AComA动脉瘤破裂的关系。结果：578例破裂动脉瘤的垂直瘤体高度为（3.57±1.96）mm、瘤颈管径为（3.07±1.17）mm、AR为1.24±0.67；72例未破裂动脉瘤的垂直瘤体高度为（2.59±1.85）mm、瘤颈管径为（2.71±1.15）mm、AR为0.97±0.60。破裂动脉瘤组的垂直瘤体高度、瘤颈管径及AR均大于未破裂动脉瘤组，2组间数据分别进行比较，差异均有统计学意义（P＜0.05）。AComA动脉瘤的AR值经ROC曲线分析后，其曲线下面积为0.64，最佳截断值为0.935。结论：AR值的大小与AComA动脉瘤破裂有明显关系，临床可将AR值做为参考因素，对AComA动脉瘤患者进行早期风险评估，降低致残率，改善预后。

A correlation study of Aspect ratio of the aneurysm and the risk of rupture

Objective: To investigate the relationship between the aspect ratio (AR) of the anterior communicating artery (AComA) aneurysm and aneurysm rupture. Methods: A retrospective analysis of 650 consecutive patients with single AcoA aneurysms between October 2010 and January 2016 in the First Affiliated Hospital of Wenzhou Medical University was conducted. There were 578 patients with ruptured AcomA aneurysms and 72 with un-ruptured AcomA aneurysms. The diameter of perpendicular height and aneurysm neck was re-measured using CT angiography images and the relationship between the AR and aneurysm rupture status was analyzed. Results: In ruptured aneurysm group, the perpendicular height was (3.57±1.96) mm, the neck size was (3.07±1.17) mm, and the AR was 1.24±0.67. In un-ruptured aneurysm group, the perpendicular height was (2.59±1.85) mm, the neck size was (2.71±1.15) mm, and the AR was 0.97±0.60. The perpendicular height, neck size and AR of ruptured aneurysms were larger than the unruptured, with significant difference (P<0.05) between them. The AR of AComA aneurysms was analyzed by ROC curve. The area under the curve was 0.64, and the optimal cut-off value was 0.935. Conclusion: The AR size was significantly related to the rupture of AComA aneurysms. In clinical practice, the AR could be considered a reference factor that may aid in risk evaluation of these patients.