颅内动脉分叉部血管结构与分叉部动脉瘤形成的相关性研究  

The Study of Correlation of Intracranial Arterial Bifurcation Vascular Structures and Bifurcation Aneurysm Formation

作　　者：肖峰[1] 詹仁雅[1] 潘剑威[1] 

机构地区：[1]浙江大学医学院附属第一医院神经外科,310006

出　　处：《心脑血管病防治》2015年第5期362-365,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：浙江省卫生厅科技计划项目(编号:2008A055)

摘　　要：目的通过回顾性采集颅内动脉分叉部的血管形态几何参数,分析血管结构与动脉瘤发生的相关性,为后期前瞻性研究提供理论依据。方法通过回顾确诊颅内动脉瘤的病例资料,得到可以进行颈内-后交通动脉分叉部分叉角、颈内动脉和后交通动脉直径测量的颈内-后交通动脉分叉部动脉瘤共14例为研究组,非颈内-后交通动脉分叉部动脉瘤共15例为对照组。分别测量两组的颈内-后交通动脉分叉部分叉角(Ap),后交通动脉直径(Dp),颈内动脉C6段(DC6)与C7段直径(DC7),统计分析颈内-后交通动脉分叉部血管形态几何参数与动脉瘤发生的相关性。结果研究组颈内-后交通动脉分叉部分叉角明显小于对照组(P<0.01)。根据分叉角进行分层,对分叉角在84°至120°的病例,进行颈内-后交通动脉分叉部血管直径的第二次统计分析,结果显示研究组的后交通动脉直径明显小于对照组(P<0.05);研究组后交通动脉与C6段直径比值明显小于对照组(P<0.05)。结论颈内-后交通动脉分叉部分叉角的大小与颈内-后交通动脉分叉部动脉瘤的形成相关,分叉角越小越有可能形成动脉瘤;而在一定分叉角范围内,后交通动脉与颈内动脉直径的比值与颈内-后交通动脉分叉部动脉瘤的形成具有相关性,比值越小越有可能形成动脉瘤。Objective Retrospective collecting morphology geometrical parameters of blood vessels of bifurcations,intracranial artery,analyzing the relationship between geometry of artery and the incidence of aneurysm to provide the theoretical basis for prospective study later. Methods 14 patients who have Pcom A aneurysms（ cases） and those of 15 patients with aneurysms at other sites（ Acom A or MCA e. g.）（ controls） were selected. Then the diameters of C6（ DC6）,C7（ DC7） and Pcom A（ Dp） at 5mm away from the crotch of the Pcom A bifurcation and the Pcom A bifurcation angle（ Ap） were measured. Then compare the data by using Student t test. Results We analyzed the diameters and the angels of the bifurcation of Pcom A,The mean angles of the Pcom A bifurcation were 88. 93° ± 19. 63° in the 14 cases and 113. 27° ± 13. 73° in the 15 controls（ P 0.01）. Then the data was ranked by the bifurcation angle,and the data range from 84° to 120°-16 patients in all for diameters comparison. The mean of diameters of the Pcom A was（ 1. 42 ± 0. 23） mm in the 7 cases and（ 1. 87 ± 0. 42） mm in the 9 controls（ P 0. 05）,and the mean of ratio（ Dp / DC6） was（ 0. 46 ± 0. 11） in the 7 cases and（ 0. 59 ± 0. 09） in the 9 controls（ P 0. 05）. Conclusions Sharper bifurcation angles are risk factors associated with the presence of aneurysms at Pcom A bifurcation. And in a certain range of angle,84° to 120° in the study,larger diameter of outlet vessel would be a protective factor to prevent the presence of intracranial aneurysm at Pcom A bifurcation.

关 键 词：数字减影血管成像 血流动力学 颅内动脉瘤 后交通动脉 

分 类 号：R743.3[医药卫生—神经病学与精神病学]