双干型大脑中动脉分叉部几何形态与动脉瘤形成的CT血管成像研究  

Computed Tomography Angiography of Geometrical Morphology of Double Trunk Middle Cerebral Artery Bifurcation and Formation of Aneurysm

作　　者：张伟[1] 王娟[1] 李婷 ZHANG Wei;WANG Juan;LI Ting(Department of Radiology,Brain Hospital of Hunan Province,Changsha 410011,China)

机构地区：[1]湖南省脑科医院放射科,湖南长沙410011 [2]湖南省湘雅三医院放射科,湖南长沙410013

出　　处：《中国医学影像学杂志》2018年第2期90-93,共4页Chinese Journal of Medical Imaging

基　　金：湖南省卫生计生委课题(B2016027)

摘　　要：目的探讨双干型大脑中动脉(MCA)分叉部动脉瘤形成与分叉部几何形态参数之间的关系,为筛选动脉瘤高危人群、降低动脉瘤破裂的病死率及致残率提供参考。资料与方法回顾性分析2014年1月-2017年3月湖南省脑科医院收治的30例MCA分叉部动脉瘤患者(动脉瘤组)与50例行头部CT血管成像(CTA)检查无动脉瘤患者(对照组),分别测量两组患者MCA两分支夹角,即分支分别与主干形成的夹角(较粗分支与主干夹角记为γ1、较细分支与主干夹角记为γ2),分叉角(γ3),分叉部血管管径和分支管径;计算两分支夹角比(较大分支夹角/较小分支夹角)及分支管径比(较粗分支/较细分支)。比较对照组和动脉瘤组各项参数间的差异。结果动脉瘤组γ1、γ2、分叉部血管管径均小于对照组,γ3大于对照组,差异均有统计学意义(P<0.05);管径比、两分支夹角比差异无统计学意义(P>0.05)。结论双干型MCA分叉部动脉瘤形成与MCA分叉部几何形态参数具有一定关联。通过CTA获得MCA分叉部几何形态参数的方法对动脉瘤高危人群筛选具有一定的价值。Purpose To investigate the correlation between the formation of double trunk middle cerebral artery（MCA） bifurcation aneurysm and the geometrical morphology parameters of MCA bifurcation to provide a reference for the screening of high-risk groups of aneurysms and reducing mortality and disability rate of ruptured aneurysms. Materials and Methods Thirty patients with MCA bifurcation aneurysm（aneurysm group） and 50 patients without aneurysm confirmed by head CTA（control group） admitted to Brain Hospital of Hunan Province from January 2014 to March 2017 were retrospectively analyzed. Angles of bilateral MCA branches of the patients in the two groups were measured respectively, namely angles of branches with main trunk（angle of coarser branch with main trunk was recorded as γ1 and that of finer branch with main trunk as γ2）, branch angles（γ3） and diameter of bifurcation vessel and daughter arteries. Branches angle ratio（larger branches angle/smaller branched angle） and branches diameter ratio（coarser branches/finer branches） were calculated. Difference of each parameter in the control group and aneurysm group was compared. Results Differences of γ1, γ2, γ3 and diameter of bifurcation vessel between aneurysm group and control group was of statistical significance（P〈0.05）. Difference of diameter ratio and branches angle ratio was of no statistical significance（P〈0.05）. Conclusion The formation of double trunk MCA bifurcation aneurysm is to certain degree correlated with the geometrical morphology parameters of MCA bifurcation. The geometrical morphology parameters of MCA bifurcation obtained by CTA are valuable for screening high-risk groups of aneurysm.

关 键 词：颅内动脉瘤 大脑中动脉 体层摄影术 X线计算机 脑血管造影术 图像处理 计算机辅助 

分 类 号：R732.2[医药卫生—肿瘤] R445.3[医药卫生—临床医学]