颅内破裂动脉瘤的大小和位置。
Size and location of ruptured intracranial aneurysms.
作者信息
Jeong Young-Gyun, Jung Yong-Tae, Kim Moo-Seong, Eun Choong-Ki, Jang Sang-Hwan
机构信息
Department of Neurosurgery, Inje University College of Medicine, Busan Paik Hospital, Busan, Korea.
出版信息
J Korean Neurosurg Soc. 2009 Jan;45(1):11-5. doi: 10.3340/jkns.2009.45.1.11. Epub 2009 Jan 31.
OBJECTIVE
The aim of study was to review our patient population to determine whether there is a critical aneurysm size at which the incidence of rupture increases and whether there is a correlation between aneurysm size and location.
METHODS
We reviewed charts and radiological findings (computed tomography (CT) scans, angiograms, CT angiography, magnetic resonance angiography) for all patients operated on for intracranial aneurysms in our hospital between September 2002 and May 2004. Of the 336 aneurysms that were reviewed, measurements were obtained from angiograms for 239 ruptured aneurysms by a neuroradiologist at the time of diagnosis in our hospital.
RESULTS
There were 115 male and 221 female patients assessed in this study. The locations of aneurysms were the middle cerebral artery (MCA, 61), anterior communicating artery (ACoA, 66), posterior communicating artery (PCoA, 52), the top of the basilar artery (15), internal carotid artery (ICA) including the cavernous portion (13), anterior choroidal artery (AChA, 7), A1 segment of the anterior cerebral artery (3), A2 segment of the anterior cerebral artery (11), posterior inferior cerebellar artery (PICA, 8), superior cerebellar artery (SCA, 2), P2 segment of the posterior cerebral artery (1), and the vertebral artery (2). The mean diameter of aneurysms was 5.47+/-2.536 mm in anterior cerebral artery (ACA), 6.84+/-3.941 mm in ICA, 7.09+/-3.652 mm in MCA and 6.21+/-3.697 mm in vertebrobasilar artery. The ACA aneurysms were smaller than the MCA aneurysms. Aneurysms less than 6 mm in diameter included 37 (60.65%) in patients with aneurysms in the MCA, 43 (65.15%) in patients with aneurysms in the ACoA and 29 (55.76%) in patients with aneurysms in the PCoA.
CONCLUSION
Ruptured aneurysms in the ACA were smaller than those in the MCA. The most prevalent aneurysm size was 3-6 mm in the MCA (55.73%), 3-6 mm in the ACoA (57.57%) and 4-6 mm in the PCoA (42.30%). The more prevalent size of the aneurysm to treat may differ in accordance with the location of the aneurysm.
目的
本研究旨在回顾我们的患者群体，以确定是否存在一个关键的动脉瘤大小，在此大小下破裂发生率会增加，以及动脉瘤大小与位置之间是否存在相关性。
方法
我们回顾了2002年9月至2004年5月间在我院接受颅内动脉瘤手术的所有患者的病历和影像学检查结果（计算机断层扫描（CT）、血管造影、CT血管造影、磁共振血管造影）。在回顾的336个动脉瘤中，我院神经放射科医生在诊断时从血管造影中获取了239个破裂动脉瘤的测量数据。
结果
本研究共评估了115例男性和221例女性患者。动脉瘤的位置包括大脑中动脉（MCA，61个）、前交通动脉（ACoA，66个）、后交通动脉（PCoA，52个）、基底动脉顶端（15个）、包括海绵窦段的颈内动脉（ICA，13个）、脉络膜前动脉（AChA，7个）、大脑前动脉A1段（3个）、大脑前动脉A2段（11个）、小脑后下动脉（PICA，8个）、小脑上动脉（SCA，2个）、大脑后动脉P2段（1个）和椎动脉（2个）。大脑前动脉（ACA）动脉瘤的平均直径为5.47±2.536毫米，颈内动脉为6.84±3.941毫米，大脑中动脉为7.09±3.652毫米，椎基底动脉为6.21±3.697毫米。ACA动脉瘤比MCA动脉瘤小。直径小于6毫米的动脉瘤在MCA动脉瘤患者中占37个（60.65%），在ACoA动脉瘤患者中占43个（65.15%），在PCoA动脉瘤患者中占29个（55.76%）。
结论
ACA破裂动脉瘤比MCA破裂动脉瘤小。MCA中最常见的动脉瘤大小为3 - 6毫米（55.73%），ACoA中为3 - 6毫米（57.57%），PCoA中为4 - 6毫米（42.30%）。根据动脉瘤的位置，更常见的待治疗动脉瘤大小可能会有所不同。
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