Cerebrovascular and Endovascular Division, Department of Neurosurgery, Tufts Medical Center, Boston, Massachusetts 02111, USA.
J Neurointerv Surg. 2013 May;5(3):201-6. doi: 10.1136/neurintsurg-2012-010285. Epub 2012 Mar 3.
Wall thickness is a poorly documented characteristic of cerebral aneurysms which may provide insight into adaptive aneurysmal growth, aneurysm rupture risk and response to endovascular treatment. The distribution of aneurysm wall thickness, as observed by intraoperative video microscopy, is described.
54 unruptured saccular cerebral aneurysms were selected based on the availability of intraoperative video obtained from patients undergoing microsurgical clipping. Aneurysms were assessed for the distribution of wall thickness based on color translucence and quantitation of pixel values at superthin translucent, intermediate and thick regions of the dome. The data were analyzed with respect to aneurysm morphology, location and associated demographic factors.
The mean proportions of tissue characteristic among all domes analyzed were found to be 27% superthin, 65% intermediate, and 8% thick. Smaller aneurysms having a maximal dimension Dmax <7 mm had a higher proportion of superthin tissue (p=0.003) and lower thick tissue (p=0.001) content. Female gender was associated with a significantly higher proportion of superthin tissue at the aneurysm dome (p=0.038), with no statistical dependence seen with patient age, smoking status or anatomical location.
The dome of unruptured aneurysms is a highly heterogeneous region with areas of variable thickness that appear to be intimately related to the process of aneurysm development. This inconstant property affects wall tensile stress, may play a role in aneurysm pathogenesis and focal rupture, and should be incorporated into future analyses of aneurysm rupture risk and mechanics.
壁厚度是脑动脉瘤的一个记录较差的特征，它可能为适应动脉瘤生长、动脉瘤破裂风险和血管内治疗反应提供深入了解。描述了术中视频显微镜观察到的动脉瘤壁厚度的分布。
根据接受显微夹闭手术的患者获得的术中视频的可用性，选择了 54 个未破裂的囊状脑动脉瘤。根据瘤顶的超薄片、中间片和厚片区域的颜色透明度和像素值定量，评估动脉瘤壁厚度的分布。根据动脉瘤形态、位置和相关人口统计学因素分析数据。
分析的所有瘤顶的组织特征的平均比例分别为 27%超薄片、65%中间片和 8%厚片。最大尺寸 Dmax<7mm 的较小动脉瘤具有更高比例的超薄片组织（p=0.003）和更低比例的厚片组织（p=0.001）。女性性别与瘤顶的超薄片组织比例显著相关（p=0.038），但与患者年龄、吸烟状况或解剖位置无关。
未破裂动脉瘤的瘤顶是一个高度异质的区域，有不同厚度的区域，这些区域似乎与动脉瘤发展过程密切相关。这种不定的特性影响壁拉伸应力，可能在动脉瘤发病机制和局部破裂中发挥作用，应纳入未来对动脉瘤破裂风险和力学的分析中。
