本文選題：顱內(nèi)動(dòng)脈瘤 + 形態(tài)學(xué)　； 參考：《臨床放射學(xué)雜志》2017年01期

【摘要】：目的研究顱內(nèi)動(dòng)脈瘤(IA)形態(tài)學(xué)參數(shù)與其破裂風(fēng)險(xiǎn)的關(guān)系,初探CTA預(yù)測動(dòng)脈瘤破裂的風(fēng)險(xiǎn)。方法搜集本院2014年6月至2015年4月經(jīng)手術(shù)和CTA診斷為動(dòng)脈瘤的110例患者(129個(gè)動(dòng)脈瘤)。對于多發(fā)動(dòng)脈瘤,依據(jù)CT平掃時(shí)蛛網(wǎng)膜下腔出血類型或者手術(shù)結(jié)果判定動(dòng)脈瘤是否破裂,將其分為破裂組和未破裂組。動(dòng)脈瘤形態(tài)學(xué)參數(shù)包括瘤頸寬度(N)、瘤體大小及形狀、瘤體深度與瘤頸寬度的比值(AR)、瘤體深度與載瘤動(dòng)脈直徑的比值(SR)、瘤頸寬度與載瘤動(dòng)脈直徑的比值(NPR)、動(dòng)脈瘤面積與瘤頸處載瘤動(dòng)脈面積的比值。采用單變量和多變量Logistic回歸分析計(jì)算動(dòng)脈瘤破裂的獨(dú)立危險(xiǎn)因素。結(jié)果 110例IA患者,男29例,女81例,中位年齡(60.6±11.3)歲。IA前三位的好發(fā)位置是后交通動(dòng)脈(46個(gè))、大腦中動(dòng)脈(30個(gè))、大腦前動(dòng)脈(26個(gè))。破裂率前三位的位置是后交通動(dòng)脈(38.6%)、大腦前動(dòng)脈(25.0%)、大腦中動(dòng)脈(22.7%)。單變量統(tǒng)計(jì)分析顯示動(dòng)脈瘤的大小、位置、AR、SR,面積比值和不規(guī)則的瘤壁在破裂組和未破裂組中具有顯著差異。以動(dòng)脈瘤的位置、不規(guī)則的瘤壁、性別和年齡作為調(diào)節(jié)變量,多變量分析顯示動(dòng)脈瘤大小≥3.85(AOR 2.913;95%CI 1.196~7.093),AR≥1.448(AOR 3.118;95%CI 1.230~7.903),SR≥1.388(AOR 5.245;95%CI 1.965~13.998)和面積比≥1.192(AOR 4.407;95%CI 1.569~12.379),是動(dòng)脈瘤破裂的危險(xiǎn)因素。結(jié)論大的動(dòng)脈瘤及其面積比值,高的AR及SR值是獨(dú)立于動(dòng)脈瘤位置、瘤壁形態(tài)和患者性別、年齡的破裂危險(xiǎn)因素。
[Abstract]:Objective to study the relationship between the morphological parameters of intracranial aneurysm (IA) and its risk of rupture. Methods 110 patients (129 aneurysms) diagnosed as aneurysms by CTA from June 2014 to April 2015 were collected. For multiple aneurysms, according to the type of subarachnoid hemorrhage during plain CT scan or the result of operation, the aneurysms were divided into ruptured group and unruptured group. The morphological parameters of the aneurysm include the width of the neck (N), the size and shape of the tumor. The ratio of tumor depth to neck width (AR), the ratio of tumor depth to the diameter of the aneurysm carrier artery (SR), the ratio of the width of the aneurysm to the diameter of the aneurysm carrier artery (NPR), and the ratio of the aneurysm area to the area of the aneurysm bearing artery at the neck of the aneurysm. Univariate and multivariate logistic regression analysis was used to calculate the independent risk factors of aneurysm rupture. Results among 110 patients with IA, 29 were males and 81 were females. The median age was (60.6 鹵11.3) years old. The predilection locations of IA were posterior communicating artery (46), middle cerebral artery (30) and anterior cerebral artery (26). The first three sites of rupture rate were posterior communicating artery (38.6%), anterior cerebral artery (25.0%) and middle cerebral artery (22.7%). Univariate statistical analysis showed that the size, location, area ratio and irregular wall of aneurysms were significantly different between ruptured and unruptured groups. According to the location of aneurysm, irregular wall, sex and age, multivariate analysis showed that the size of aneurysm 鈮，

本文編號(hào)：2053832