Department of Neurosurgery and Neurotraumatology, Jagiellonian University Medical College, Botaniczna 3 Street, 31-503, Kraków, Poland.
TENSOR- Team of NeuroSurgery-Oriented Research, Jagiellonian University Medical College, Kraków, Poland.
Eur Radiol. 2019 Nov;29(11):6309-6318. doi: 10.1007/s00330-019-06146-3. Epub 2019 Apr 11.
We decided to perform computer-aided analysis of the anterior cerebral artery (ACA) to check for a potential correlation with anterior communicating artery (ACoA) aneurysm presence and growth.
We retrospectively analyzed the ACA anatomy of 121 patients with ACoA aneurysms along with 121 age, risk factors, and vessel side-matched control patients without an ACoA aneurysm. We obtained their medical history and digital subtraction angiography (DSA) data from their medical records. For each patient's DSA, we extracted curve representing the course of their ACA and calculated its relative length (RL), sum of angle metrics (SOAM), triangular index (TI), product of angle distance (PAD), and inflection count metrics (ICM).
Patients with ACoA aneurysm had significantly higher RL (0.64 ± 0.23 vs. 0.56 ± 0.22; p < 0.01), SOAM (0.27 ± 0.19 vs. 0.18 ± 0.15; p < 0.01), PAD (0.12 ± 0.13 vs. 0.09 ± 0.11; p = 0.02), and TI (0.57 ± 0.14 vs. 0.44 ± 0.15; p < 0.01). In multivariate logistic regression analysis, after adjustment for possible confounders, SOAM (OR, 1.34; 95% CI, 1.12-1.63; p < 0.01) and TI (OR, 1.84; 95% CI, 1.47-2.35; p < 0.01) remained independently associated with higher risk of ACoA aneurysm. Additionally, we found significant negative correlations between TI and aneurysm dome size (R = - 0.194; p = 0.047).
Increased tortuosity of ACA might increase the risk of ACoA aneurysm development and decrease the risk of aneurysm growth.
• Anterior cerebral artery's sum of angle metrics is associated with hypertension as well as with history of ischemic stroke and myocardial infarction. • Increased tortuosity of anterior cerebral artery might be associated with anterior communicating artery aneurysm development. • Tortuosity of anterior cerebral artery is negatively correlated with anterior communicating artery aneurysm dome size.
我们决定对大脑前动脉（ACA）进行计算机辅助分析，以检查其与前交通动脉（ACoA）动脉瘤存在和生长之间的潜在相关性。
我们回顾性分析了 121 例 ACoA 动脉瘤患者和 121 例年龄、危险因素和血管侧匹配的无 ACoA 动脉瘤对照患者的 ACA 解剖结构。我们从病历中获取了他们的病史和数字减影血管造影（DSA）数据。对于每位患者的 DSA，我们提取了代表其 ACA 过程的曲线，并计算了其相对长度（RL）、角度度量总和（SOAM）、三角指数（TI）、角度距离乘积（PAD）和弯曲计数度量（ICM）。
ACoA 动脉瘤患者的 RL（0.64±0.23 与 0.56±0.22；p<0.01）、SOAM（0.27±0.19 与 0.18±0.15；p<0.01）、PAD（0.12±0.13 与 0.09±0.11；p=0.02）和 TI（0.57±0.14 与 0.44±0.15；p<0.01）显著升高。在多变量逻辑回归分析中，调整可能的混杂因素后，SOAM（OR，1.34；95%CI，1.12-1.63；p<0.01）和 TI（OR，1.84；95%CI，1.47-2.35；p<0.01）仍然与 ACoA 动脉瘤的高风险独立相关。此外，我们发现 TI 与动脉瘤瘤顶大小之间存在显著负相关（R=-0.194；p=0.047）。
ACA 的迂曲增加可能会增加 ACoA 动脉瘤发生的风险，并降低动脉瘤生长的风险。
ACA 的角度度量总和与高血压、缺血性卒中和心肌梗死病史有关。
ACA 的迂曲增加可能与 ACoA 动脉瘤的发生有关。
ACA 的迂曲程度与 ACoA 动脉瘤瘤顶大小呈负相关。
