Hademenos G J, Massoud T F, Turjman F, Sayre J W
Department of Radiological Sciences, UCLA School of Medicine and Medical Center, Los Angeles, California, USA.
Neuroradiology. 1998 Nov;40(11):755-60. doi: 10.1007/s002340050679.
The size of intracranial aneurysms is the only characteristic shown to correlate with their rupture. However, the critical size for rupture has varied considerably among previous accounts and remains a point of controversy. Our goal was to identify statistically significant clinical and morphological factors predictive of the occurrence of rupture and aneurysm size in patients referred for endovascular treatment. We retrospectively recorded the following factors from 74 patients who presented with ruptured (40) or unruptured (34) aneurysms: aneurysm morphology (uni/multilobulated), location (anterior/posterior), maximum diameter, diameter of the neck, and the patient's age and sex. We performed stepwise discriminant, and stepwise and logistic regression analysis to identify factors predicting rupture and the size of the aneurysm at rupture. The mean diameter of the ruptured aneurysms was 11.9+/-6.3 mm, range 3.0-33.0 mm, and that of the unruptured aneurysm 13.5+/-5.8 mm, range 5.0-30 mm. Stepwise discriminant analysis identified aneurysm morphology (P < 0.001) and location in the intracranial circulation (P < 0.001) as statistically significant factors in predicting rupture. Stepwise regression analysis revealed that aneurysm morphology and the size of the neck were predictors of aneurysm size at rupture.
颅内动脉瘤的大小是唯一被证实与动脉瘤破裂相关的特征。然而，关于破裂的临界大小，以往的报道差异很大，仍是一个有争议的问题。我们的目标是确定在接受血管内治疗的患者中，具有统计学意义的、可预测破裂发生及动脉瘤大小的临床和形态学因素。我们回顾性记录了74例出现破裂（40例）或未破裂（34例）动脉瘤患者的以下因素：动脉瘤形态（单叶/多叶）、位置（前/后）、最大直径、颈部直径以及患者的年龄和性别。我们进行了逐步判别分析、逐步回归分析和逻辑回归分析，以确定预测破裂及破裂时动脉瘤大小的因素。破裂动脉瘤的平均直径为11.9±6.3mm，范围为3.0 - 33.0mm，未破裂动脉瘤的平均直径为13.5±5.8mm，范围为5.0 - 30mm。逐步判别分析确定动脉瘤形态（P < 0.001）和颅内循环位置（P < 0.001）是预测破裂的统计学显著因素。逐步回归分析显示，动脉瘤形态和颈部大小是破裂时动脉瘤大小的预测因素。
