颅内动脉瘤破裂风险评估中CTA的有效性及形态学特征分析

目的探讨颅内动脉瘤（intracranial aneurysm，IA）风险评估中CT血管造影成像（CTA）应用有效性，并对其形态学特征进行系统分析。方法回顾性研究2017年1月至2019年5月103例IA病人临床资料，对比破裂和未破裂者CTA影像形态学表现，并分析与瘤体破裂的相关性。结果103例病人中，瘤体破裂78例（84个瘤体），未破裂瘤体25例（28个瘤体）；IA破裂以后交通动脉为主，其次是前交通动脉、大脑中动脉、大脑前动脉、后循环，差异有统计学意义（P < 0.05）；破裂组和未破裂组病人的瘤体大小、瘤体位置、瘤体高度和瘤颈宽度比（AR）、瘤体深度和载瘤动脉直径比（SR）、动脉瘤面积与瘤颈处载瘤动脉面积比值（面积比）及子囊数差异均有统计学意义（P < 0.05~P < 0.01）；logistic回归分析表明，瘤体大小、AR、SR、面积比是动脉瘤瘤体破裂独立危险因素（P < 0.05）。结论CTA可清晰、准确显示颅内动脉瘤形态学特征，瘤体大小、AR、SR及面积比等形态学表现可作为IA破裂风险的独立评估指标。

Analysis of the CTA effectiveness in the assessment of the rupture risk of intracranial aneurysm,and its morphological characteristics

ObjectiveTo explore the effectiveness of CT angiography(CTA) in the risk assessment of intracranial aneurysm(IA), and systematically analyze its morphological features.MethodsThe clinical data of 103 patients with IA from January 2017 to may 2019 were retrospectively analyzed.The CTA image morphology between ruptured and unruptured patients was compared, and its correlation with tumor rupture was analyzed.ResultsAmong 103 patients, 78 cases(84 tumors) ruptured, and 25 cases(28 tumors) did not rupture.The rupture of traffic artery was mainly after IA, followed by anterior communicating artery, middle cerebral artery, anterior cerebral artery and posterior circulation, and the difference between the anterior and posterior cerebral arteries was statistically significant(P < 0.05).The differences of the tumor size, tumor location, tumor height, tumor neck width ratio(AR), tumor depth to tumor carrier artery diameter ratio(SR), area ratio(ratio of aneurysm area to tumor neck carrier artery area ratio) and number of sac between the ruptured group and non ruptured group were statistically significant(P < 0.05 to P < 01).The results of logistic regression analysis showed that the tumor size, AR, SR and area ratio were the independent risk factors of aneurysm rupture(P < 0.05).ConclusionsCTA can clearly and accurately reflect the morphological features of intracranial aneurysms.The morphological findings such as tumor size, AR, SR and area ratio can be used as the independent evaluation indicators of IA rupture risk.