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1、颅内动脉瘤形态学特征及破裂风险CTA评估李剑秋，陈莉，姚开情，勒都晓兰,吕发金（400016重庆,重庆医科大学附属第一医院放射科）［摘要］目的研究颅内动脉瘤的形态学特征与破裂风险的关系，初步预测动脉瘤的破裂风险。方法回顾性分析154例194个颅内动脉瘤资料，其中破裂组61例（82个动脉瘤）和未破裂组93例（112个动脉瘤），测量瘤体长度、瘤颈宽度，计算瘤体长度与瘤颈宽度的比值（AR值），观察有无子囊、子囊个数及位置，分析以上指标与破裂的相关性。结果破裂组平均瘤体长度（4.95±4.80）mm，瘤颈宽度（3.55±3.10）mm，AR值（1.21±0.68）,47.
2、6%有子囊；未破裂组平均瘤体长度（2.75±2.65）mm，瘤颈宽度（2.85±1.90）mm，AR值（0.96±0.55），14.3%有子囊。两组间有无子囊的比较差异有统计学意义（P＜0.05）。颅内动脉瘤破裂的临界瘤体长度、瘤颈宽度和AR值分别为3.65、3.35mm和1.135；瘤颈宽度＜3.35mm时的破裂风险是＞3.35mm时的2.05倍，瘤体长度＞3.65mm时的破裂风险是＜3.65mm时的3.76倍，AR值＞1.135时的破裂风险是＜1.135时的3.18倍，有子囊的破裂风险是无子囊的5.64倍。结论颅内动脉瘤的瘤体长度、瘤颈宽度、AR值和子囊形成是
3、动脉瘤破裂的危险因素，瘤体越长、瘤颈越小、AR值越大或有子囊形成，动脉瘤破裂风险越大。［关键词］颅内动脉瘤；形态学特征；瘤体长度；瘤颈宽度；AR值；子囊［中图法分类号］R764.93；R732.2［文献标志码］AMorphologicalfeaturesofintracranialaneurysmanditsruptureriskassessmentLiJianqiu,ChenLi,YaoKaiqing,LeduXiaolan,LuFajin（DepartmentofRadiology,FirstAffiliatedHospital,ChongqingMedica
4、lUniversity,Chongqing,400016,China）［Abstract］ObjectiveTodeterminetherelationshipbetweenthemorphologicalfeaturesandruptureriskofintracerebralaneurysm.MethodsAnretrospectiveanalysiswascarriedoutontheclinicaldataof194intracranialaneurysmsin154patients(61with82rupturedaneurysmsand93with11
5、2ruptured)whodiagnosedinourhospitalformDeember2009toJune2011.Theirthree-dimensionalgeometrieswereevaluatedforarangeofmorphologicalparameters.Theparametersincludeddepth,neckwidth,aspectratio(AR),withdaughtersacornot,andnumberandpositionofdaughtersac.ResultsThemeandepth,neckwidthandARwe
6、re4.95±4.80mm,3.55±3.10mm,1.21±0.68respecivelyforthepatientswithrupturedaneurysms,and2.75±2.65mm,2.85±1.90mm,and0.96±0.55respectivelyforthosewithunrupturedaneurysms.Significantdifferencewasfoundintheaneurysmswithdaughtersacornotbetweentherupturedandunrupturedgroups（P＜0.05）.Thecritical
7、valuesofdepth,neckwidthandARinintracranialaneurysmsforruptureriskwere3.65mm,3.35mmand1.135respectively.Theaneurysmswithdepthover3.65mmhadtheriskofruptureby3.76timeshigherthanthosewithlesserdepth.Theaneurysmswithneckwidthlessthan3.35hadtheriskby3.18timeshigherthanthosewithwidthlarger.W
8、henAR
