颈内动脉-后交通动脉分叉部动脉瘤与动脉圆锥周围血管的形态学差异研究  

Morphological differences between internal carotid-posterior communicating artery bifurcation aneurysm and vessels around the infundibulum

作　　者：余梦楠[1] 洪波[1] 刘建民[1] 

机构地区：[1]中国人民解放军第二军医大学长海医院神经外科,上海200433

出　　处：《中国微侵袭神经外科杂志》2009年第9期422-425,共4页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的分析颈内动脉-后交通动脉(ICA-PComA)分叉部动脉瘤与动脉圆锥周围血管的形态学特点。方法以22个ICA-PComA动脉瘤(动脉瘤组)与20个动脉圆锥(动脉圆锥组)为研究对象,通过3D-DSA对颈内动脉交通段直径(Dica)、后交通动脉起始部直径(Dpcom)、颈内动脉与后交通动脉起始部夹角角度(Apcom)及颈内动脉眼段-床突段转折处角度(Aica)等进行测量。采用两独立样本t检验及Logistic回归对结果进行统计分析;对与动脉瘤发生具有相关性的参数进行受试者工作特线曲线(ROC)分析。结果两组Dpcom、Aica和Apcom差异有统计学意义(P<0.05);Apcom减小导致动脉瘤发生概率增加。Apcom的ROC曲线下面积为0.913,最佳诊断界值为52.25°。结论Apcom对ICA-PComA动脉瘤与动脉圆锥的鉴别及对动脉瘤的预测具有重要参考价值。Objective To analyze the morphological features of internal carotid artery-posterior communicating artery （ICA-PComA） aneurysms and the vessels around the infundibulums. Methods Twenty two ICA-PComA aneurysms and 20 infundibulums were observed. The morphological parameters obtained from three-dimensional digital subtraction angiography （3D-DSA） were evaluated, including the diameters of the ICA segment and origin of PComA （Dica and Dpcom）, the included angle between ICA and the origin of the PComA （Apcom）, and the angle between the ophthalmic segment and clinoid segment reversal site of the ICA （Aica）. Parameters were analyzed with two-tailed independent-samples t test and logistic regression analysis. ROC analysis was performed for the parameters related to aneurysmogenesis. Results Statistically significant differences were found in the value of Dpcom, Aica and Apcom between the two groups （P〈0.05）. Decrease of Apcom could lead to the increase of aneurysmogenesis probability. The area under the ROC curve of Apcom was 0.913; threshold for optimal diagnosis was 52.25 degree. Conclusion Apcom is a promising morphological parameter in the differential diagnosis of aneurysm and infundibulum, and also for the prediction of aneurysm formation.

关 键 词：颅内动脉瘤 动脉圆锥 颈内动脉 后交通动脉 血管造影术 数字减影 成像 三维 

分 类 号：R651[医药卫生—外科学]