基于CT形态学特征的颅内多发动脉瘤破裂相关因素分析  

CT Based Morphological Analysis for Rupture Risk of Multiple Intracranial Aneurysms

作　　者：谢智雯 骆雅婷 李雨蒙 汪秀玲 XIE Zhiwen;LUO Yating;LI Yumeng(Department of Radiology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu Province 221000,P.R.China)

机构地区：[1]徐州医科大学附属医院影像科,221000

出　　处：《临床放射学杂志》2023年第11期1713-1717,共5页Journal of Clinical Radiology

摘　　要：目的基于CT形态学参数,比较颅内多发动脉瘤破裂组与未破裂组的形态学特征,并分析颅内多发动脉瘤破裂相关风险因素。方法回顾性搜集31例患者的临床及影像学资料。所有患者均经颅内血管造影(DSA)或手术确诊。31例颅内多发动脉瘤患者共66个动脉瘤,66个颅内动脉瘤按是否破裂分为破裂组(31个)和未破裂组(35个)。将CTA影像在工作站上进行重建后处理,获得动脉瘤最大径、纵横比(SR)、尺寸比(AR)、入射角、不规则形态等动脉瘤形态特征;利用动脉瘤最大径、位置、形态进行动脉瘤特异性预测分数计算。采用SPSS 26.0统计学软件进行数据处理,符合正态分布的计量资料,两组间比较采用t检验;非正态分布的计量资料,两组间比较采用Mann-Whitney U检验。χ2检验或Fisher精确概率。以P<0.05为差异有统计学意义。结果与未破裂动脉瘤组相比,破裂动脉瘤组最大径、AR、SR、入射角、不规则形态在破裂动脉瘤与非破裂动脉瘤组间比较差异有统计学意义(均P<0.05)。破裂组以后交通动脉、大脑中动脉、前交通动脉最常见,后交通动脉占比最大;未破裂组动脉瘤以颈内动脉居多。破裂组的动脉瘤特异性预测分数显著高于非破裂组,差异具有统计学意义(P<0.05)。结论动脉瘤最大径、SR、AR、入射角、不规则形态是判断颅内多发动脉瘤破裂状态的可靠形态学参数,动脉瘤特异性预测分数判断颅内多发动脉瘤破裂状态具有较高诊断准确性。Objective To compare the morphological features of multiple intracranial aneurysms on CT angiography(CTA),and to elucidate the rupture risk factors of intracranial aneurysms.Methods The clinical and imaging data of 31 patients were retrospectively evaluated.All patients were diagnosed by intracranial angiography(DSA)or operation.There were 66 aneurysms in 31 patients with multiple intracranial aneurysms.66 intracranial aneurysms were divided into ruptured group(n=31)and unruptured group(n=35).SPSS 26.0 version was used for statistical analysis.The CTA images were reconstructed on the workstation,and the aneurysm morphological features such as maximum diameter,SR,AR,incident angle and irregular shape were obtained.The aneurysm-specific prediction scores were calculated by using the maximum diameter,location and shape of the aneurysm.The t-test was used for comparison of measurement data following the normal distribution,while Mann-Whitney U test was used for measurement data not following the normal distribution.Results The maximum diameter,AR,SR,incident angle and rregular shape of the ruptured aneurysm group was higher than the non-ruptured aneurysm group(all P<0.05).PcomA,AcomA and MCA were the most common sites in the ruptured aneurysm group.ICA were the most common sites in the non-ruptured aneurysm group.The aneurysm-specific prediction scores in the ruptured group was higher than that in the non-ruptured group(P<0.05).Conclusion The maximum diameter,SR,AR,incident angle and rregular shape were considered as a reliable morphological parameters to distinguish the ruptured status of multiple intracranial aneurysms.The aneurysm-specific prediction score has a high diagnostic accuracy in judging the ruptured state of multiple intracranial aneurysms.

关 键 词：放射学 颅内多发动脉瘤 破裂 形态学 预测评分模型 

分 类 号：R816.1[医药卫生—放射医学] R743[医药卫生—临床医学]