Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.
Eur J Radiol. 2023 Aug;165:110941. doi: 10.1016/j.ejrad.2023.110941. Epub 2023 Jun 20.
To investigate the association of tortuosity of the main cerebral arteries with intracranial aneurysm (IA) occurrence and rupture. To investigate the relationship between arterial tortuosity and aneurysm morphology as well as conventional risk factors of vascular diseases.
Three subject groups were analyzed in this study: Patients with ruptured IAs, patients with unruptured IAs, and healthy subjects. The groups were matched by sex and age using tendency score matching. Their intracranial magnetic resonance angiography (MRA) images were collected retrospectively. The intracranial arterial structures were segmented from the MRA images. Arterial tortuosity was measured and statistically compared between the different subject groups and different vessels. Correlation analysis was conducted between arterial tortuosity and clinical risk factors as well as aneurysm morphology.
120 patients were included in the study (average age: 67.5 years; 60% female), 40 for each group after matching. The tortuosity of the aneurysm-bearing artery was significantly greater than that of the contralateral artery in both the ruptured and unruptured IA groups (p < 0.001). There was no significant association between clinical risk factors (history of hypertension, hyperlipidemia, diabetes, smoking, and alcohol use) and arterial tortuosity. There were significant negative correlations between aneurysm-bearing artery tortuosity and aneurysm morphological features such as maximal diameter (p = 0.0011), neck diameter (p < 0.0001), maximum height (p = 0.0024), and size ratio (p = 0.0269).
The occurrence of cerebral aneurysms correlates to increased unilateral arterial tortuosity, but the risk of aneurysm enlargement/rupturing decreases with greater arterial tortuosity. Abnormal tortuosity may be congenital as tortuosity has no clear connection with acquired common risk factors of vascular diseases.
研究大脑主要动脉迂曲与颅内动脉瘤（IA）发生和破裂的关系。研究动脉迂曲与动脉瘤形态以及血管疾病常见危险因素之间的关系。
本研究分析了 3 组受试者：破裂的颅内动脉瘤患者、未破裂的颅内动脉瘤患者和健康受试者。使用倾向评分匹配法按性别和年龄对各组进行匹配。回顾性收集他们的颅内磁共振血管造影（MRA）图像。从 MRA 图像中分割颅内动脉结构。测量并比较不同受试者组和不同血管之间的动脉迂曲程度。进行了动脉迂曲与临床危险因素和动脉瘤形态之间的相关性分析。
研究纳入了 120 名患者（平均年龄：67.5 岁；60%为女性），匹配后每组 40 名。在破裂和未破裂的 IA 组中，动脉瘤所在动脉的迂曲程度明显大于对侧动脉（p<0.001）。临床危险因素（高血压、高血脂、糖尿病、吸烟和饮酒史）与动脉迂曲之间无显著相关性。动脉瘤所在动脉的迂曲程度与动脉瘤形态特征（最大直径、颈直径、最大高度和大小比）呈显著负相关（p=0.0011、p<0.0001、p=0.0024、p=0.0269）。
脑动脉瘤的发生与单侧动脉迂曲增加有关，但随着动脉迂曲程度的增加，动脉瘤增大/破裂的风险降低。异常迂曲可能是先天性的，因为迂曲与后天获得的血管疾病常见危险因素没有明确的关系。
