Tian Zhongbin, Zhang Yisen, Jing Linkai, Liu Jian, Zhang Ying, Yang Xinjian
Department of Interventional Neuroradiology, Beijing Neurosurgical Institute, Beijing Tian Tan Hospital, Capital Medical University , Beijing , China.
Medical Center, Tsinghua University, Beijing, China; Department of Neurosurgery, Medical Center, Beijing Tsinghua Changgung Hospital, Tsinghua University, Beijing, China.
Front Neurol. 2016 Dec 5;7:219. doi: 10.3389/fneur.2016.00219. eCollection 2016.
The purpose of this research was to analyze the effect of morphologic and hemodynamic characteristics on mirror aneurysms in which one ruptured and the other did not, within the same patient, and to identify reliable predictors of rupture.
We performed three-dimensional angiographic imaging in 56 patients with intracranial mirror aneurysms for computational fluid dynamic studies from January 2009 to December 2015. The ruptured aneurysm simulations were conducted with geometry obtained after rupture. The significance of morphologic and hemodynamic parameters with respect to rupture was analyzed. Multivariate logistic regression analysis was applied to significant parameters to identify independent discriminators.
Three morphologic factors (aneurysm size, aspect ratio, and size ratio) and two hemodynamic factors [time-averaged mean wall shear stress (WSS) and low WSS area] were statistically associated with aneurysm rupture ( < 0.05). On multivariate logistic regression, a larger size (OR 2.572, = 0.001) and lower WSS (OR 0.609, = 0.045) were independent significant factors for rupture.
Larger aneurysm size and lower WSS were independently associated with the rupture status of aneurysms. These findings need to be confirmed by large multicenter and multi-population studies.
本研究旨在分析同一患者中一个破裂而另一个未破裂的镜像动脉瘤的形态学和血流动力学特征对其的影响，并确定可靠的破裂预测因素。
2009年1月至2015年12月，我们对56例颅内镜像动脉瘤患者进行了三维血管造影成像，以进行计算流体动力学研究。破裂动脉瘤的模拟采用破裂后获得的几何形状进行。分析了形态学和血流动力学参数与破裂的相关性。对显著参数进行多因素逻辑回归分析，以确定独立的判别因素。
三个形态学因素（动脉瘤大小、纵横比和大小比）和两个血流动力学因素[时间平均平均壁面切应力（WSS）和低WSS区域]与动脉瘤破裂在统计学上相关（<0.05）。多因素逻辑回归分析显示，较大的尺寸（OR 2.572，=0.001）和较低的WSS（OR 0.609，=0.045）是破裂的独立显著因素。
较大的动脉瘤尺寸和较低的WSS与动脉瘤的破裂状态独立相关。这些发现需要通过大型多中心和多人群研究来证实。
