Zhai Xiaodong, Geng Jiewen, Zhu Chengcheng, Yu Jiaxing, Li Chuanjie, Jiang Nan, Xiang Sishi, Fang Gang, Hu Peng, Zhang Hongqi
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
China International Neuroscience Institute, Beijing, China.
Front Neurosci. 2021 Nov 18;15:759806. doi: 10.3389/fnins.2021.759806. eCollection 2021.
Although pericallosal artery aneurysms (PAAs) are relatively uncommon, accounting for only 1-9% of all intracranial aneurysms (IAs), they exhibit a considerably high propensity to rupture. Nevertheless, our current knowledge of the risk factors for PAA rupture is still very limited. To fill this gap, we investigated rupture risk factors for PAAs based on morphological computer-assisted semiautomated measurement (CASAM) and hemodynamic analysis. Patients with PAAs were selected from the IA database in our institute and their baseline data were collected. Morphological parameters were measured in all enrolled patients by applying CASAM. Computational fluid dynamics simulation (CFD) was performed to evaluate the hemodynamic difference between ruptured and unruptured PAAs. From June 2017 to June 2020, among 2141 patients with IAs in our institute, 47 had PAAs (2.2%). Thirty-one patients (mean age 57.65 ± 9.97 years) with 32 PAAs (20 unruptured and 12 ruptured) were included in the final analysis. Comparing with unruptured PAAs, ruptured PAAs had significantly higher aspect ratio (AR), mean normalized wall shear stress (NWSS), and mean oscillatory shear index (OSI) values than the unruptured PAAs (all < 0.05) in univariate analyses. Multivariable analysis showed that a high mean OSI was an independent risk factor for PAA rupture (OR = 6.45, 95% CI 1.37-30.32, = 0.018). This preliminary study indicates that there are morphological and hemodynamic differences between ruptured and unruptured PAAs. In particular, a high mean OSI is an independent risk factor for PAA rupture. Further research with a larger sample size is warranted in the future.
尽管胼周动脉瘤（PAA）相对少见，仅占所有颅内动脉瘤（IA）的1% - 9%，但其破裂倾向相当高。然而，我们目前对PAA破裂危险因素的了解仍然非常有限。为了填补这一空白，我们基于形态学计算机辅助半自动测量（CASAM）和血流动力学分析，对PAA的破裂危险因素进行了研究。从我们研究所的IA数据库中选取患有PAA的患者，并收集他们的基线数据。通过应用CASAM对所有纳入患者测量形态学参数。进行计算流体动力学模拟（CFD）以评估破裂和未破裂PAA之间的血流动力学差异。2017年6月至2020年6月，在我们研究所的2141例IA患者中，47例患有PAA（2.2%）。最终分析纳入了31例患者（平均年龄57.65±9.97岁），共32个PAA（20个未破裂，12个破裂）。在单因素分析中，与未破裂的PAA相比，破裂的PAA具有显著更高的纵横比（AR）、平均归一化壁面切应力（NWSS）和平均振荡剪切指数（OSI）值（均P < 0.05）。多变量分析显示，高平均OSI是PAA破裂的独立危险因素（OR = 6.45，95%CI 1.37 - 30.32，P = 0.018）。这项初步研究表明，破裂和未破裂的PAA之间存在形态学和血流动力学差异。特别是，高平均OSI是PAA破裂的独立危险因素。未来有必要进行更大样本量的进一步研究。
