CT血管造影对颅内动脉瘤破裂的危险因素分析

目的 探讨CT血管造影（CT angiography,CTA）形态学参数在评估颅内动脉瘤破裂风险中的应用价值。方法 回顾性分析兰溪市人民医院2016年12月至2021年12月收治的113例颅内动脉瘤患者的临床资料，以数字减影血管造影（digitalsubtractionangiography,DSA）和CTA检查结果为判断依据，将发生动脉瘤破裂患者纳入破裂组（n=75），未发生动脉瘤破裂患者纳入未破裂组（n=38）。测量载瘤动脉直径（carrier artery diameter,Dv），计算瘤体深度与宽度比值（ratio of tumor depth to width,AR）、瘤颈宽度与载瘤动脉直径比值（ratio of tumor neck width to parent artery diameter,NPR）、瘤体深度与载瘤动脉直径比值（size ratio,SR）、动脉瘤面积与瘤颈处载瘤动脉面积比值（面积比）。采用Logistic回归分析颅内动脉瘤破裂影响因素，受试者操作特征曲线分析CTA形态学参数对颅内动脉瘤破裂的预测价值。结果CTA检查出动脉瘤未破裂有44个，破裂有85个...

Study on the risk factors of intracranial aneurysm rupture by CT angiography morphological parameters

Objective To explore the application value of morphological parameters of CT angiography (CTA) in evaluating the risk of intracranial aneurysm rupture. Methods The clinical data of 113 patients with intracranial aneurysms treated in our hospital from December 2016 to December 2021 were retrospectively analyzed. Based on the results of digital subtraction angiography (DSA) and CTA, the ruptured aneurysms were included in the ruptured group (n=75), and the non-ruptured aneurysms were included in the unruptured group (n=38). The diameter of the parent artery (Dv) was measured, and the ratio of tumor depth to width (AR), the ratio of tumor neck width to parent artery diameter (NPR), the ratio of tumor depth to parent artery diameter (SR) and the ratio of aneurysm area to parent artery area (area ratio) were calculated. Logistic regression was used to analyze the influencing factors of intracranial aneurysm rupture, and receiver operator characteristic (ROC) was used to analyze the predictive value of CTA morphological parameters for intracranial aneurysm rupture. Results CTA detected 44 unruptured aneurysms, 85 ruptured aneurysms, 2 unruptured aneurysms misdiagnosed as ruptured aneurysms and 1 ruptured aneurysm missed diagnosis. Taking DSA as the gold standard, the accuracy of CTA in diagnosing ruptured intracranial aneurysms was 97.73%. The size, AR, SR, area ratio and the number of irregular aneurysm walls in the ruptured group were significantly higher than those in the unruptured group (P<0.05), and there was a significant difference in the location of aneurysm between the two groups (P<0.05). Aneurysm size, AR, SR and area ratio are independent risk factors of intracranial aneurysm rupture (P<0.05). The area under the curve predicted by aneurysm size, AR, SR and area ratio is 0.724, 0.678, 0.685 and 0.692, respectively. Conclusion Clinical CTA monitoring of morphological parameters of intracranial aneurysms can predict the risk of rupture to a certain extent, provide scientific and favorable data support for subsequent prevention and treatment plans, and have important significance for improving the treatment outcome and prognosis of patients.