基于CTA 形态学及血液炎症指标分析大脑中动脉动脉瘤破裂的风险因素  

Analysis of Risk Factors for the Rupture of Middle Cerebral Artery AneurysmBased on CTA Morphology and Blood Inflammation Index

作　　者：姜兵 张伟[1] JIANG Bing;ZHANG Wei(Clinical College,Hunan University of Traditional Chinese Medicine(Department of Radiology,Hunan Brain Hospital))

机构地区：[1]湖南中医药大学临床学院(湖南省脑科医院放射科)

出　　处：《中国医学计算机成像杂志》2024年第1期17-21,共5页Chinese Computed Medical Imaging

基　　金：湖南省自然科学基金(2018JJ6013)。

摘　　要：目的:分析大脑中动脉(MCA)动脉瘤破裂的风险因素,筛选基于动脉瘤形态学和血液炎症细胞的动脉瘤破裂预测指标。方法:回顾性分析2018年1月至2023年4月经过头颅CT血管成像(CTA)确诊的MCA动脉瘤90例,根据CT平扫有无蛛网膜下腔出血和/或脑内血肿,分为未破裂组(53例)和破裂组(37例),未破裂动脉瘤(UIA)组根据形态分为形态规则组和形态不规则组,比较年龄,性别,入院第一次血常规炎症细胞及计算而得的中性粒细胞与淋巴细胞比值(NLR)、全身性系统炎症反应指数(SIRI),动脉瘤形态学参数等。通过卡方检验、Student's t检验或曼-惠特尼U检验分析各组因素,对差异因素进行单因素及多因素逻辑回归分析,最后以ROC曲线对动脉瘤形态学、血液炎症细胞有差异性的因素进行诊断效能评估。结果:MCA动脉瘤形态不规则(OR=8.64,P=0.0063)、SIRI(OR=13.62,P=0.042)、长宽比(OR=25.92,P=0.043)是独立破裂风险因素,其AUC值分别是0.78、0.94、0.75。结论:MCA动脉瘤形态不规则、长宽比和SIRI是动脉瘤破裂的高危险因素,对预测动脉瘤破裂有重要意义。Purpose:To explore the risk factors for the rupture of middle cerebral artery(MCA)aneurysm and to identify predictors of aneurysm rupture based on aneurysm morphological features and the proportions of each kind of immune cells.Methods:From January 2018 to April 2023,90 cases of MCA aneurysm patients diagnosed using cranial CT angiography(CTA)were retrospectively analyzed and divided into two groups:unruptured(53 cases)and ruptured(37 cases)based on the presence or absence of subarachnoid hemorrhage and/or intracerebral hemorrhageon CT plain scanning.The unruptured aneurysm(UIA)group was further subdivided into morphologically regular and morphologically irregular group based on aneurysm morphological features.Comparisons were carried among age,gender,proportions of each immune cells during the first admission blood routine,the neutrophil-to-lymphocyte ratio(NLR),the systemic inflammatory response index(SIRI),and morphological features such as aspect-ratios of the aneurysm.The factors in each group were analyzed by Chi-squared test,Student's t-test or Mann-Whitney U-test.Factors with significant differences(P<0.05)were then subjected to univariate and multivariate logistic regression analyses,and diagnostic accuracy was assessed by ROC(receiver operating characteristic)analysis.Results:MCA aneurysm morphological irregularity(OR=8.64,P=0.0063),SIRI(OR=13.62,P=0.042),and aspect-ratio(OR=25.92,P=0.043)were independent rupture risk factors with AUC values of 0.78,0.94,and 0.75,respectively.Conclusion:MCA aneurysm morphological irregularity,aspect-ratios,and SIRI are independent risk factors for aneurysm rupture with significant prognostic significance.

关 键 词：大脑中动脉动脉瘤 破裂 计算机体层成像 危险因素 

分 类 号：R445.3[医药卫生—影像医学与核医学]