Jiang Yunzhao, Lan Qing, Wang Qihong, Lu Hua, Ge Feng, Wang Yong
Department of Neurosurgery, Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou, 215004, Jiangsu, People's Republic of China.
Cell Biochem Biophys. 2014 Nov;70(2):1417-20. doi: 10.1007/s12013-014-0074-6.
The purpose of this study is to evaluate the association of the location and geometric parameters of intracranial aneurysm with the risk of rupture. A retrospective study consisted of 284 patients diagnosed with saccular intracranial aneurysm between January 2009 and May 2013 at Wuxi Third People's Hospital was conducted. 3D digital subtraction angiography images from all patients (240 ruptured, 44 unruptured) were obtained and analyzed. The location of the aneurysms and the 3D geometric parameters including the aneurysm depth, the neck size, diameter of the parent artery, aneurysm angle, aspect radio, size ratio, and the neck-to-parent-artery ratio (NPR) were compared between ruptured and unruptured groups.
In ruptured group, anterior communicating artery, posterior communicating artery (PCoA), and the bifurcation of internal carotid artery (ICA) were the top three locations for aneurysm occurrence, accounting for 40.00, 30.42, and 12.08 % respectively. While in the unruptured group, top three locations were PCoA (36.36 %), posterior cerebral circulation (18.18 %), and the bifurcation of the ICA (15.91 %). Distribution of aneurysm location is significantly different (p < 0.05) between ruptured and unruptured aneurysms. For the 3D geometric parameters characterizing aneurysm, aneurysm depth (p < 0.05), parent artery diameter (p < 0.05), aneurysm angle (p < 0.01), aspect ratio (p < 0.01), and size ratio (p < 0.01) all showed a significant difference between ruptured and unruptured group. No difference was found in the neck size and the NPR ratio between the two groups. 3D geometric parameters such as aneurysm depth, parent artery diameter, aneurysm angle, aspect ratio, and size ratio can be helpful in evaluating the rupture risk of saccular intracranial aneurysm for a better prevention and prognosis.
本研究的目的是评估颅内动脉瘤的位置和几何参数与破裂风险之间的关联。进行了一项回顾性研究，该研究纳入了2009年1月至2013年5月在无锡市第三人民医院被诊断为囊状颅内动脉瘤的284例患者。获取并分析了所有患者（240例破裂，44例未破裂）的三维数字减影血管造影图像。比较了破裂组和未破裂组之间动脉瘤的位置以及三维几何参数，包括动脉瘤深度、瘤颈大小、载瘤动脉直径、动脉瘤角度、纵横比、大小比以及瘤颈与载瘤动脉比值（NPR）。
在破裂组中，前交通动脉、后交通动脉（PCoA）以及颈内动脉（ICA）分叉处是动脉瘤发生的前三位位置，分别占40.00%、30.42%和12.08%。而在未破裂组中，前三位位置是PCoA（36.36%）、后循环（18.18%）以及ICA分叉处（15.91%）。破裂和未破裂动脉瘤之间的动脉瘤位置分布存在显著差异（p < 0.05）。对于表征动脉瘤的三维几何参数，动脉瘤深度（p < 0.05）、载瘤动脉直径（p < 0.05）、动脉瘤角度（p < 0.01）、纵横比（p < 0.01）和大小比（p < 0.01）在破裂组和未破裂组之间均显示出显著差异。两组之间的瘤颈大小和NPR比值未发现差异。诸如动脉瘤深度、载瘤动脉直径、动脉瘤角度、纵横比和大小比等三维几何参数有助于评估囊状颅内动脉瘤的破裂风险，以实现更好的预防和预后。
