修正后-大小比(c-SR)值对颅脑动脉瘤破裂风险研究价值  

The study value of corrected-size ratio(c-SR)value on risk of rupture of craniocerebral aneurysm

作　　者：刘亚飞 陈为军 许洋 赵玉 张南 刘雪姣 张宝华 张丽燕 LIU Yafei;CHEN Weijun;XU Yang;ZHAO Yu;ZHANG Nan;LIU Xuejiao;ZHANG Baohua;ZHANG Liyan(Department of Radiology,Hospital of No.82 Group of PLA,Baoding,Hebei Province 071000,China;Department of Outpatient,Hospital of No.82 Group of PLA,Baoding,Hebei Province 071000,China)

机构地区：[1]陆军第82集团军医院医学影像科,河北保定071000 [2]陆军第82集团军医院门诊部,河北保定071000

出　　处：《实用放射学杂志》2025年第3期381-384,共4页Journal of Practical Radiology

摘　　要：目的 探讨颅内动脉容积CT血管成像(CTA)修正后-大小比(c-SR)值对预测颅内动脉瘤破裂风险的价值.方法 选取有复查随诊记录的81例动脉瘤患者,其中未破裂动脉瘤随访患者39例,未破裂动脉瘤手术患者9例,破裂动脉瘤手术患者33例.通过患者CTA进行三维重建并获取动脉瘤形态学参数,获取动脉瘤首次大小比(SR)值及复查SR值或术后c-SR值.分析未破裂动脉瘤SR值随访变化情况;动脉瘤术前SR值及术后c-SR值变化情况.对比未破裂动脉瘤首次SR值与破裂动脉瘤c-SR值的相关性.结果 未破裂动脉瘤首次SR值与随访SR值无统计学差异(P>0.05);未破裂动脉瘤术前SR值与术后c-SR值无统计学差异(P>0.05);破裂动脉瘤术前SR值与术后c-SR值有统计学差异(P<0.05);未破裂动脉瘤首次SR值与破裂动脉瘤术后c-SR值有统计学差异(P<0.05).将未破裂动脉瘤首次SR值与破裂动脉瘤术后c-SR值进行受试者工作特征(ROC)曲线分析,其曲线下面积(AUC)为0.860,最佳截断值为1.045.结论 未破裂动脉瘤在相当长的时间内保持稳定,形态学参数无明显变化.手术不会影响动脉瘤SR值.动脉瘤破裂蛛网膜下腔出血会引起载瘤动脉血管变细,进而夸大破裂动脉瘤术前SR值,导致破裂动脉瘤术前SR值失真;术后c-SR值才是动脉瘤破裂前真实的SR值.Objective To explore the value of the corrected-size ratio(c-SR)value of intracranial volume computed tomography angiography(CTA)in predicting the risk of intracranial aneurysm rupture.Methods A total of 81 patients with aneurysms who had follow-up records were selected.Among them,39 patients with unruptured aneurysms and underwent regular follow-ups,while 9 patients with unruptured aneurysms opted for surgical intervention.Additionally,surgery was performed on 33 patients with ruptured aneurysms.Three-dimensional reconstruction of CTA was performed to obtain the morphological parameters of aneurysms.The initial size ratio(SR)value of aneurysm and the follow-up SR value or postoperative c-SR value were obtained.The changes in SR values of unruptured aneurysms were analyzed,the preoperative SR values and postoperative c-SR values of aneurysms were analyzed.Finally,the correlation between the intial SR value of unruptured aneurysms and the c-SR value of ruptured aneurysms was compared.Results No significant difference was observed between the initial SR value of unruptured aneurysms and the follow-up SR value(P>0.05).Similarly,no significant difference was noted between the preoperative SR value of unruptured aneurysms and the postoperative c-SR value(P>0.05).The preoperative SR value of ruptured aneurysms differed significantly from the postoperative c-SR value(P<0.05).There was a significant difference between the initial SR value of unruptured aneurysms and the postoperative c-SR value of ruptured aneurysms(P<0.05).The receiver operating characteristic(ROC)curve analysis was performed on the initial SR value of unruptured aneurysms and the postoperative c-SR value of ruptured aneurysms.The area under the curve(AUC)was 0.860 and the best cut-off value was 1.045.Conclusion Unruptured aneurysms remain stable for an extended period of time,exhibiting no significant change in morphological parameters.It can be concluded that surgical intervention does not affect the SR value of aneurysms.In the case of subarachnoid h

关 键 词：大小比 颅内动脉瘤 破裂 CT血管成像 

分 类 号：R732.21[医药卫生—肿瘤] R814.43[医药卫生—临床医学]