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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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

Received: 06 January 2019

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	YANG Sisi
	GUO Xianzhong
	XIA Nengzhi
	CHEN Yongchun
	SHUI Xujuan
	YANG Yunjun

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https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2019/V49/I9/686

[1] STEINER T, JUVELA S, UNTERBERG A, et al. European stroke organization guidelines for the management of intracranial aneurysms and subarachnoid haemorrhage[J]. Cerebrovasc Dis, 2013, 35(2): 93-112.
[2] MIRA J M, COSTA F A, HORTA B L, et al. Risk of rupture in unruptured anterior communicating artery aneurysms: meta-analysis of natural history studies[J]. S urg Neurol, 2006, 66 Suppl 3: S12-19.
[3] VLAK M H, ALGRA A, BRANDENBURG R, et al. Prevalence of unruptured intracranial aneurysms, with emphasis on sex, age, comorbidity, country, and time period: A systematic review and meta-analysis[J]. Lancet Neurol, 2011, 10(7): 626-636.
[4] WEIR B, AMIDEI C, KONGABLE G, et al. The aspect ratio (dome/neck) of ruptured and unruptured aneurysms[J]. J Neurosurg, 2003, 99(3): 447-451.
[5] ELSHARKAWY A, LEHEČKA M, NIEMELÄ M, et al. Anatomic risk factors for middle cerebral artery aneurysm rupture: computed tomography angiography study of 1009 consecutive patients[J]. Neurosurgery, 2013, 73(5): 825-836.
[6] HOH B L, SISTROM C L, FIRMENT C S, et al. Bottleneck factor and height-width ratio: Association with ruptured aneurysms in patients with multiple cerebral aneurysms[J]. Neurosurgery, 2007, 61(4): 716-723.
[7] FORGET T R, BENITEZ R, VEZNEDAROGLU E, et al. A review of size and location of ruptured intracranial aneu-rysms[J]. Neurosurgery, 2001, 49(6): 1322-1326.
[8] UCAS Japan Investigators, MORITA A, KIRINO T, et al. The natural course of unruptured cerebral aneurysms in a Japanese Cohort[J]. N Engl J Med, 2012, 366(26): 2474-2482.
[9] 宋剑平, 毛颖, 宋冬雷, 等. 颅内囊性动脉瘤几何特征与破裂风险的关系[J]. 中华医学杂志, 2009, 89(11): 732-735.
[10] LAURIC A, BAHAROGLU M I, MALEK A M. Ruptured status discrimination performance of aspect ratio, height/width, and bottleneck factor is highly dependent on aneurysm sizing methodology[J]. Neurosurgery, 2012, 71(1): 38-46.
[11] UJIIE H, TAMANO Y, SASAKI K, et al. Is the aspect ratio a reliable index for predicting the rupture of a saccular aneurysm?[J]. Neurosurgery, 2001, 48(3): 495-523.
[12] BACKES D, VERGOUWEN M D I, VELTHUIS B K, et al. Difference in aneurysm characteristics between ruptured and unruptured aneurysms in patients with multiple intracranial aneurysms[J]. Stroke, 2014, 45(5): 1299-1303.
[13] KASHIWAZAKI D, KURODA S. Size ratio can highly predict rupture risk in intracranial small (<5 mm) aneurysms[J]. Stroke, 2013, 44(8): 2169-2173.