垂直瘤体高度/瘤颈管径比值与动脉瘤破裂风险的相关性

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摘要目的：探讨前交通动脉（AComA）动脉瘤垂直瘤体高度与瘤颈管径的比值（AR）与动脉瘤破裂的关系。方法：回顾性分析2010年10月至2016年1月温州医科大学附属第一医院神经外科收治的650例AComA动脉瘤患者的动脉瘤形态参数，其中破裂动脉瘤578例，未破裂动脉瘤72例。分别收集2组动脉瘤的垂直瘤体高度及瘤颈管径，同时分析两者的比值AR值与AComA动脉瘤破裂的关系。结果：578例破裂动脉瘤的垂直瘤体高度为（3.57±1.96）mm、瘤颈管径为（3.07±1.17）mm、AR为1.24±0.67；72例未破裂动脉瘤的垂直瘤体高度为（2.59±1.85）mm、瘤颈管径为（2.71±1.15）mm、AR为0.97±0.60。破裂动脉瘤组的垂直瘤体高度、瘤颈管径及AR均大于未破裂动脉瘤组，2组间数据分别进行比较，差异均有统计学意义（P＜0.05）。AComA动脉瘤的AR值经ROC曲线分析后，其曲线下面积为0.64，最佳截断值为0.935。结论：AR值的大小与AComA动脉瘤破裂有明显关系，临床可将AR值做为参考因素，对AComA动脉瘤患者进行早期风险评估，降低致残率，改善预后。

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	杨思思
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	杨运俊

关键词 ：颅内动脉瘤, 前交通动脉, 破裂风险, AR值

Abstract：Objective: To investigate the relationship between the aspect ratio (AR) of the anterior communicating artery (AComA) aneurysm and aneurysm rupture. Methods: A retrospective analysis of 650 consecutive patients with single AcoA aneurysms between October 2010 and January 2016 in the First Affiliated Hospital of Wenzhou Medical University was conducted. There were 578 patients with ruptured AcomA aneurysms and 72 with un-ruptured AcomA aneurysms. The diameter of perpendicular height and aneurysm neck was re-measured using CT angiography images and the relationship between the AR and aneurysm rupture status was analyzed. Results: In ruptured aneurysm group, the perpendicular height was (3.57±1.96) mm, the neck size was (3.07±1.17) mm, and the AR was 1.24±0.67. In un-ruptured aneurysm group, the perpendicular height was (2.59±1.85) mm, the neck size was (2.71±1.15) mm, and the AR was 0.97±0.60. The perpendicular height, neck size and AR of ruptured aneurysms were larger than the unruptured, with significant difference (P<0.05) between them. The AR of AComA aneurysms was analyzed by ROC curve. The area under the curve was 0.64, and the optimal cut-off value was 0.935. Conclusion: The AR size was significantly related to the rupture of AComA aneurysms. In clinical practice, the AR could be considered a reference factor that may aid in risk evaluation of these patients.

Key words： intracranial aneurysms anterior communicating artery rupture risk aspect ratio

收稿日期: 2019-01-06

基金资助:温州市基础性医疗卫生科技项目（Y20180114）；浙江省卫生创新人才项目；浙江省高等学校中青年学科带头人项目。

通讯作者: 杨运俊，主任医师，Email：yyjunjim@163.com。

作者简介: 杨思思（1983-），女，浙江温州人，主治医师。

链接本文:

https://xb.wmu.edu.cn/CN/ 或 https://xb.wmu.edu.cn/CN/Y2019/V49/I9/686

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