Stroke Center, Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450000, Henan Province, China.
Sci Rep. 2023 Dec 21;13(1):22844. doi: 10.1038/s41598-023-50380-1.
To investigate the relationship of the middle cerebral artery (MCA) bifurcation aneurysms with patients' age and sex, vascular angles at the bifurcation, and diameters of the M1 and two M2 arteries, patients with and without MCA aneurysms were retrospectively enrolled. The lateral angles, MCA bifurcation angle and arterial diameter were measured and analyzed. Totally, 121 (19.0%) patients with and 517 (81.0%) without MCA aneurysms were enrolled. Most (n = 88 or 72.7%) aneurysms were present in the age range of 40-70 years, and significantly (P = 0.01) more women than men had the bifurcation aneurysms. The MCA bifurcation angle was significantly greater (149.2° ± 32.6° vs. 107.2° ± 26.3°; P < 0.0001) while both the smaller and larger lateral (M1/M2) angles were significantly smaller in patients with than without aneurysms (82.0° ± 23.7° vs. 109.1° ± 22.7° with P < 0.001 for the smaller and 123.2° ± 25.2° vs. 139.5° ± 16.9° with P < 0.001 for the larger lateral angle). 109 (90.1%) bifurcation aneurysms deviated towards the smaller lateral angle, and 103 (85.1%) aneurysms deviated towards the thinner M2 branch. The maximal aneurysm diameter ranged 1.6-13.8 (mean 5.4 ± 2.4) mm and was significantly (P < 0.05) positively correlated with the diameter of both M2 arterial branches (R = 0.57 and P = 0.01 for the smaller M2, and R = 0.69 and P = 0.002 for the larger M2) or the MCA bifurcation angle. A significant (P < 0.0001) negative correlation was detected between age and the smaller lateral angle but a significant (P < 0.0001) positive correlation between age and the MCA bifurcation angle in patients without MCA bifurcation aneurysms or in the total patients. MCA bifurcation angle was the only significant (P = 0.0001, odds ratio 2.7, 95% confidence interval 1.6-3.8) independent risk factor for MCA bifurcation aneurysm presence, with the bifurcation angle threshold of 124.1° and an area under the ROC curve of 0.86. In conclusion, significantly more MCA bifurcation aneurysms are present in older patients, females, and patients with a wider MCA bifurcation angle, and deviate towards the smaller lateral angle and the thinner M2 segment. MCA bifurcation angle is the only independent risk factor for presence of MCA bifurcation aneurysms with the threshold of 124.1°.
为了研究大脑中动脉（MCA）分叉部动脉瘤与患者年龄、性别、分叉部血管角度、M1 和两支 M2 动脉直径的关系，回顾性纳入了有和无 MCA 动脉瘤的患者。测量并分析了外侧角、MCA 分叉角度和动脉直径。共有 121 名（19.0%）有 MCA 动脉瘤的患者和 517 名（81.0%）无 MCA 动脉瘤的患者入组。大多数（n=88 或 72.7%）动脉瘤出现在 40-70 岁年龄组，且女性明显多于男性（P=0.01）。MCA 分叉角度明显较大（149.2°±32.6°比 107.2°±26.3°；P<0.0001），而较小和较大的外侧角（M1/M2）明显较小（较小的角度 P<0.001，为 82.0°±23.7°；较大的角度 P<0.001，为 123.2°±25.2°）。109 个（90.1%）分叉部动脉瘤偏向较小的外侧角，103 个（85.1%）动脉瘤偏向较细的 M2 分支。最大动脉瘤直径为 1.6-13.8（平均 5.4±2.4）mm，与两支 M2 动脉分支的直径呈显著正相关（较小的 M2 分支的 R=0.57，P=0.01；较大的 M2 分支的 R=0.69，P=0.002）或 MCA 分叉角度呈显著正相关。在无 MCA 分叉部动脉瘤的患者或所有患者中，年龄与较小的外侧角呈显著负相关（P<0.0001），而年龄与 MCA 分叉角度呈显著正相关（P<0.0001）。MCA 分叉角度是 MCA 分叉部动脉瘤存在的唯一显著（P=0.0001，优势比 2.7，95%置信区间 1.6-3.8）独立危险因素，分叉角度阈值为 124.1°，ROC 曲线下面积为 0.86。总之，MCA 分叉部动脉瘤在年龄较大的患者、女性和 MCA 分叉角度较大的患者中更为常见，且偏向较小的外侧角和较细的 M2 段。MCA 分叉角度是 MCA 分叉部动脉瘤存在的唯一独立危险因素，其阈值为 124.1°。
