基于容积CT数字减影血管成像对颈内虹吸部动脉瘤破裂风险的研究  

Study on the Risk of Aneurysm Rupture in the Siphon of the Neck Based on Volumetric CT Digital Subtraction Angiography

作　　者：黄中 姜雪[1] 蔡焰 龚启慧 吕发金[1] HUANG Zhong;JIANG Xue;CAI Yan;GONG Qihui;LÜFajin(Department of Radiology,The First Affiliated Hospital,Chongqing Medical University)

机构地区：[1]重庆医科大学附属第一医院放射科

出　　处：《中国医学计算机成像杂志》2022年第1期26-31,共6页Chinese Computed Medical Imaging

摘　　要：目的:比较破裂与未破裂虹吸部动脉瘤的形态学特征,为未破裂动脉瘤的风险评估提供参考依据。方法:回顾性分析经容积CT数字减影血管造影(VCTDSA)检查后被诊断为虹吸部动脉瘤的患者151例,其中未破裂组104例(共117个动脉瘤),破裂组47例(共49个动脉瘤),比较破裂组与未破裂组动脉瘤的形状、夹角等共21个指标,对上述指标行单因素分析,然后使用ROC曲线判断指标的灵敏度、特异度以确定最大临界值,最后用多因素logistic回归分析。结果:单因素分析中未破裂组与破裂组虹吸部动脉瘤在形状、部位、宽、高、瘤颈、大小、子母角、倾角、流入角、AR(瘤体长径/瘤颈宽)、SR(最大瘤径/载瘤动脉平均直径)、S1/S2(面积比)、最大径、瘤宽/瘤颈、年龄、多发上差异具有统计学意义。多因素分析显示瘤大小(OR=12.607,95%CI=4.400~36.124,P<0.001)、倾角(OR=4.062,95%CI=1.570~10.513,P=0.004)、是否为多发动脉瘤(OR=4.274,95%CI=1.620~11.272,P=0.003)为虹吸部动脉瘤破裂的独立危险因素。结论:颈内动脉虹吸部动脉瘤的瘤大小、倾角、是否为多发是形态学预测破裂的危险因素,其用于预测动脉瘤破裂的风险具有一定意义。Purpose:To compare the morphological characteristics of ruptured and unruptured siphon aneurysms and to provide a reference for the risk assessment of unruptured aneurysms.Methods:One hundred and fifty-one patients with siphon aneurysms who were treated with volume CT digital subtraction angiography(VCTDSA)were retrospectively analyzed.There were 104 cases(117 aneurysms)in the unruptured group and 47 cases(49 aneurysms)in the ruptured group.The shapes and angles of the aneurysms in the two groups were compared and analyzed using univariate analysis.Receiver operating characteristic(ROC)curve analysis was used to judge the sensitivity and accuracy of the indexes.Specificity was used to determine the maximum cut-off value.Results:In univariate analysis,there were significant differences in the shape,location,width,height,neck size,parent⁃child angle,inclination,inflow angle,tumor length/neck width(AR),maximum tumor diameter/average diameter of tumorcarrying artery(SR),S1/S2 area ratio,maximum diameter,width/neck ratio,age,and multiple incidences between unruptured and ruptured siphon aneurysms.Multivariate logistic regression analysis showed that tumor size(OR=12.607,95%CI=4.400-36.124,P<0.001),inclination angle(OR=4.062,95%CI=1.570-10.513,P=0.004),and multiple aneurysms(OR=4.274,95%CI=1.620-11.272,P=0.003)were independent risk factors for siphon aneurysm ruptures.Conclusion:The size,inclination angle,and multiple aneurysms in the siphon part of the internal carotid artery were the morphological risk factors for ruptures,and they have significance in predicting the risk associated with the rupture of aneurysms.

关 键 词：虹吸部动脉瘤 形态学 破裂 容积CT 

分 类 号：R445.3[医药卫生—影像医学与核医学]