[1]刘超博　黄焕斌　汪锡华　王之涵　徐　豪　任　力.颅内动脉瘤破裂风险和动脉瘤形态学参数的关系[J].中国临床神经外科杂志,2018,(02):81-84.
　LIU Chao-bo,HUANG Huan-bin,WANG Xi-hua,et al.Relationship of rupture of intracranial aneurysm with its morphology[J].,2018,(02):81-84.
点击复制

颅内动脉瘤破裂风险和动脉瘤形态学参数的关系()
分享到：

《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2018年02期
页码:
81-84
栏目:
论著
出版日期:
2018-03-05

文章信息/Info

Title:
Relationship of rupture of intracranial aneurysm with its morphology
文章编号:
1009-153X（2018）02-0081-04
作者:
刘超博　黄焕斌　汪锡华　王之涵　徐　豪　任　力
作者单位：201399，上海市浦东医院神经外科（刘超博、黄焕斌、汪锡华、王之涵、徐　豪、任　力）
Author(s):
LIU Chao-bo;  HUANG Huan-bin;  WANG Xi-hua;  WANG Zhi-han;  XU Hao;  REN Li.
Department of Neurosurgery, Pudong Hospital, Shanghai 201200, China
关键词:
颅内动脉瘤; 形态学参数; 破裂风险
Keywords:
Intracranial aneurysm;  Rupture;  Morphology parameters
分类号:
R 743.9
文献标志码:
A
摘要:
目的 探讨颅内动脉瘤破裂风险相关的动脉瘤形态学参数。方法 回顾性分析114例颅内动脉瘤（61例未破裂动脉瘤，53例破裂动脉瘤）的临床资料，采用多因素Logistic回归分析检验7个动脉瘤形态学参数[动脉瘤直径、动脉瘤高度与瘤颈宽度比值、动脉瘤高度与载瘤动脉直径比值（SR）、长宽比、入射角度、载瘤动脉角度和颈体角度）与动脉瘤破裂风险的关系。结果 动脉瘤长度越长，破裂风险越小（OR=0.470；95% CI 0.286~0.771；P=0.003）；SR越大，破裂风险越大（OR=18.998；95% CI 2.851~126.607；P=0.002）；颈体角度越大，破裂风险越大（OR=1.073；95% CI 1.023~1.125；P=0.004）。结论 SR、动脉瘤长度和颈体角度是判断颅内动脉瘤破裂风险的重要指标。
Abstract:
Objective To identify morphological parameters associated with intracranial aneurysms (IAs) rupture. Methods Seven morphological parameters were evaluated in 114 patients with saccular IAs (61 unruptured, 53 ruptured), including the ratio of aneurysmal diameter to parent artery diameter (size ratio, SR), ratio of aneurysmal height to parent artery height, ratio of aneurysmal height to aneurysmal neck width, ratio of aneurysmal height to width, angle between the parent artery longitudinal axis and aneurysmal diameter (incidence angle of blood flow) and angle between the plane where the aneurysmal neck was and the parent artery (aneurysmal inclination angle) and angle between the directions in which blood flew into and from the aneurysm (parent artery angle). The relationship of these factors with the aneurysm rupture was statistically analyzed. Results The multivariate Logistic regression analysis showed that small length of aneurysm (OR=0.470, 95% CI 0.286~0.771, P=0.003), high SR (OR=18.998, 95% CI 2.851~126.607, P=0.002) and big aneurysm inclination angle (OR=1.073, 95% CI 1.023~1.125, P=0.004) were independent risk factors related to the rupture of intracranial aneurysms. Conclusions It is suggested that the SR, aneurysmal inclination angle and length of aneurysms may be important factors related to the rupture of the intracranial aneurysms.

参考文献/References:

[1] Molyneux AJ, Clarke A, Sneade M, et al. Cerecyte coil trial angiographic outcomes of a prospective randomized trial comparing endovascular coiling of cerebral aneurysms with either cerecyte or bare platinum coils [J]. Stroke, 2012, 43 (10): 2544-2550.
[2] Dinc H, Ozturk MH, Sari A, et al. Coil embolization in 481 ruptured intracranial aneurysms: angiographic and clinical results [J]. Diagn Interv Radiol, 2013, 19(2): 165-172.
[3] Cho YD, Lee JY, Seo JH, et al. Early recurrent hemorrhage after coil embolization in ruptured intracranial aneurysms [J]. Neuroradiology, 2012, 54(7): 719-726.
[4] Beck J, Rohde S, Beltagy M, et al. Difference in configura- tion of ruptured and unruptured intracranial aneurysms determined by biplanar digital subtraction angiography [J]. Acta Neurochir (Wien), 2003, 145(10): 861-865.
[5] Forget TR Jr, Benitez R, Veznedaroglu E, et al. A review of size and location of ruptured intracranial aneurysms [J]. Neurosurgery, 2001, 49(6): 1322-1326.
[6] Raghavan ML, Ma B, Harbaugh RE. Quantified aneurysm shape and rupture risk [J]. J Neurosurg, 2005, 102(2): 355- 362.
[7] Ujiie H, Tamano Y, Sasaki K, et al. Is the aspect ratio a reli- able index for predicting the rupture of a saccular aneurysm [J]? Neurosurgery, 2001, 48(3): 495-503.
[8] Dhar S, Tremmel M, Mocco J, et al. Morphology parameters for intracranial aneurysm rupture risk assessment [J]. Neu- rosurgery, 2008, 63(2): 185-197.
[9] Baharoglu MI, Schirmer CM, Hoit DA, et al. Aneurysm inflow-angle as a discriminant for rupture in sidewall cere- bral aneurysms [J]. Stroke, 2010, 41(7): 1423-1430.
[10] Raghavan ML, Ma B, Harbaugh RE. Quanti?ed aneurysm shape and rupture risk [J]. J Neurosurg, 2005, 102(2): 355- 362.
[11] Hoh BL, Sistrom CL, Firment CS, et al. Bottleneck factor and height-width ratio: association with ruptured aneurysms in patients with multiple cerebral aneurysms [J]. Neuro- surgery, 2007, 61(4): 716-722.
[12] Meng H, Tutino VM, Xiang J, et al. High WSS or low WSS? Complex interactions of hemodynamics with intracranial aneurysm initiation,growth,and rupture: toward a unifying hypothesis [J]. Am J Neuroradio, 2014, 35(7): 1254-1262.
[13] 王芙昱，许百男. 基于影像数据的颅内动脉瘤血流动力学 的三维数据模拟的研究进展[J]. 中国临床神经外科杂 志，2008，13（3）：186-190.
[14] Cebral JR, Mut F, Weir J, et al. Quantitative characteriza- tion of the hemodynamic environment in ruptured and unruptured brain aneurysms [J]. Am J Neuroradio, 2011, 32 (1): 145-151.
[15] Schnell S, Ansari R, Vakil P, et al. Three-dimensional hemodynamics in intracranial aneurysms: influence of size and morphology [J]. J Magn Reson Imaging, 2014, 39(1): 120-131.
[16] Wiebers DO, Whisnant JP, Huston J, et al. Unruptured intracranial aneurysms--risk of rupture and risks of surgi- cal intervention [J]. N Engl J Med, 1998, 339(24): 1725- 1733.
[17] Orz Y, AlYamany M. The impact of size and location on rupture of intracranial aneurysms [J]. Asian J Neurosurg, 2015, 10(1): 26-31.
[18] Joo SW, Lee SI, Noh SJ, et al. What is the significance of a large number of ruptured aneurysms smaller than 7 mm in diameter [J]? J Korean Neurosurg Soc, 2009, 45(2): 85-89.
[19] Lai HP, Cheng KM, Yu SC, et al. Size, location, and multi- plicity of ruptured intracranial aneurysms in the Hong Kong Chinese population with subarachnoid haemorrhage [J]. Hong Kong Med J, 2009, 15(4): 262-266.
[20] Hademenos GJ, Massoud T, Valentino DJ, et al. Anonlin- ear mathematical model for the development and rupture of intracranial saccular aneurysms [J]. Neurol Res, 1994, 16 (5): 376-384.
[21] Zheng YT, Xu F, Ren J, et al. Assessment of intracranial aneurysm rupture based on morphology parameters and anatomical locations [J]. J Neurointerv Surg, 2016, 8(2): 1240-1246.
[22] Hoh BL, Sistrom CL, Firment CS, et al. Bottleneck factor and height-width ratio: association with ruptured aneury- sms in patients with multiple cerebral aneurysms [J]. Neurosurgery, 2007, 61(4): 716-722.
[23] Cebral JR, Castro MA, Burgess JE, et al. Characterization of cerebral aneurysms for assessing risk of rupture by using patient-specific computational hemodynamics models [J]. Am J Neuroradio, 2005, 26(10): 2550-2559.
[24] Hoi Y, Meng H, Woodward SH, et al. Effects of arterial geo- metry on aneurysm growth: threedimensional computational fluid dynamics study [J]. J Neurosurg, 2004, 101(4): 676- 681.
[25] 赵　诚，李宗敏，李　冰，等. 颅内动脉瘤破裂急性期血管 内栓塞治疗的疗效分析及影响因素[J]. 中国临床神经外 科杂志，2006，11（6）：372-374.

相似文献/References:

[1]曾　春　张施远　蒋永明.复合手术与常规夹闭术治疗颈内动脉后交通动脉破裂动脉瘤的疗效对比研究[J].中国临床神经外科杂志,2016,(05):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
　ZENG Chun,ZHANG Shi-yuan,JIANG Yong-ming.Analysis of the effects of hybrid surgery on posterior communicating artery aneurysms: a comparison with conventional craniotomy[J].,2016,(02):257.[doi:10.13798/j.issn.1009-153X.2016.05.001]
[2]周有东　敖祥生　刘汉东　王志勇　朱耀祖　周达全.支架辅助弹簧圈和单纯弹簧圈栓塞治疗颅内动脉瘤疗效及安全性的Meta分析[J].中国临床神经外科杂志,2016,(05):274.[doi:10.13798/j.issn.1009-153X.2016.05.006]
　ZHOU You-dong,AO Xiang-sheng,LIU Han-dong,et al.A mata-analysis of curative effects of stent-assisted coiling and simple coiling on intracranial aneurysms and their safety[J].,2016,(02):274.[doi:10.13798/j.issn.1009-153X.2016.05.006]
[3]赵　平　王雄伟　汪　雷　马金阳.显微手术和血管内栓塞术治疗颅内动脉瘤的疗效分析[J].中国临床神经外科杂志,2016,(05):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
　ZHAO Ping,WANG Xiong-wei,WANG Lei,et al.Effect of endovascular treatment on intracranial aneurysms: a comparison with microsurgery[J].,2016,(02):281.[doi:10.13798/j.issn.1009-153X.2016.05.008]
[4]李朝晖　王玉贵　张孟超 综述　赵兴利 审校.CT灌注成像在动脉瘤性蛛网膜下腔出血中的 临床应用进展[J].中国临床神经外科杂志,2016,(05):313.[doi:10.13798/j.issn.1009-153X.2016.05.021]
[5]刘福德　邓剑平　张　涛　陈　虎　李　帅　王俭博　曲友直　赵振伟.椎-基底动脉夹层动脉瘤的血管内治疗（附48例分析）[J].中国临床神经外科杂志,2016,(06):353.[doi:10.13798/j.issn.1009-153X.2016.06.011]
　LIU Fu-de,DENG Jian-ping,ZHANG Tao,et al.Endovascular treatment of vertebrobasilar artery dissecting aneurysms (report of 48 cases)[J].,2016,(02):353.[doi:10.13798/j.issn.1009-153X.2016.06.011]
[6]吴有志　罗良生　张　健　陈　骅　吴　鸣　刘　振　史　岩.前循环破裂动脉瘤伴脑内血肿的 早期显微手术治疗[J].中国临床神经外科杂志,2016,(06):376.[doi:10.13798/j.issn.1009-153X.2016.06.020]
[7]潘　力　刘　鹏　秦　杰　杨　柳　安学峰　吴　虓　杨　铭　徐国政　马廉亭.Y型支架辅助技术在颅内动脉分叉部宽颈动脉瘤治疗中的应用[J].中国临床神经外科杂志,2016,(07):394.[doi:10.13798/j.issn.1009-153X.2016.07.002]
　PAN Li,LIU Peng,QIN Jie,et al.Application of Y -configuration stent technique to treatment of intracranial wide-neck bifurcation aneurysms[J].,2016,(02):394.[doi:10.13798/j.issn.1009-153X.2016.07.002]
[8]周　量　刘　丛　张昌伟.早期栓塞术治疗动脉瘤性蛛网膜下腔出血的疗效[J].中国临床神经外科杂志,2016,(07):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
　ZHOU Liang,LIU Cong,ZHANG Chang-wei..Curative effect of early endovascular embolization on patients with ruptured intracranial aneurysms[J].,2016,(02):410.[doi:10.13798/j.issn.1009-153X.2016.07.007]
[9]张　莹　荆林凯　张倩倩　刘　健　张义森　王　坤　穆士卿　杨新健.颈内动脉后交通动脉小动脉瘤破裂危险因素分析[J].中国临床神经外科杂志,2016,(03):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
　ZHANG Ying,JING Lin-kai,ZHANG Qian-qian,et al.Analysis of risk factors related to rupture of small (diameter ≤5 mm) posterior communicating artery aneurysms[J].,2016,(02):138.[doi:10.13798/j.issn.1009-153X.2016.03.002]
[10]朱作磊 综述　罗良生 审校.动脉瘤性蛛网膜下腔出血的预后相关因素研究进展[J].中国临床神经外科杂志,2016,(03):183.[doi:10.13798/j.issn.1009-153X.2016.03.020]

备注/Memo

备注/Memo:
基金项目：上海市浦东新区卫生系统重点专科（PWZzk 2017-16） 通讯作者：任　力，E-mail：a_chao123@163.com
更新日期/Last Update: 2018-03-05