Comparative Analysis Of Morphologic Characteristics Of Ruptured And Unruptured Aneurysms

Objective Based on CTA(computed tomography angiography)and DSA(digital subtraction angiography),to research the difference of morphological characterristics of all ruptured intracerebral aneurysms and unruptured intracerebral aneurysms for patients with a history of subarachnoid hemorrhage and intracerebral mutiple aneurysms,avoid ing different individual factors-high blood pressure,diabetes,smoking,atherosclerosis and gender on the influence of the rupture of aneurysm,in order to make appropriate clinical decision and maximize benefit.Methods To retrospectively analyze 83 cases of patients of the first neurosurgery ward of the first hospital affiliated to dalian medical university in November 2014 to November 2016,which have a history of SAH and MIA.To analyze morphological parameters of 58 patients with clear responsibility of 58 RIA and 76 UIA,which have complete clinical data and improve CTA or DSA examination.The characteristics of aneurysms were evaluated on 3D-DSA and CTA.We collected five one-dimensional indices [neck width(Wn),height(H),length(L),width(W),parent vessel average diameter(Dv)] and four two-dimensional indices [aspect ratio(AR),height-width ratio(HWR),bottleneck factor(BN),size ratio(SR)].Results The maximum diameter of the ruptured aneurysms and the unruptured aneurysms respectively(5.50 ± 2.21)(3.77 ± 1.84),there are statistically significant(t=4.809,P<0.01).The ruptured incidence of aneurysm in <3 mm(10),>3mm to <5mm(15),>5mm to <7 mm(13)and >7 mm(20)were 20.80%,47%,50% and 71.8.0%,respectively.thereare statistically significant(X2=18.235,P< 0.01)(P<0.001)The parameters of ruptured and unruptured aneurysms single factor analysis as shown in table 1,it can be seen ruptured intracerebral aneurysms and unruptured intracerebral aneurysms in Wn,H,AR,L,SR,W,BN differences were statistically significant(P < 0.01),and the difference in the Dv and WHR parameters is not significant.AR and SR area under the curve were 0.79,0.756,to react aneurysm rupture has better sensitivity and specificity.Binary classification unconditioned logistic regression model,AR and SR were independent factors affecting the aneurysm rupture,see table 3,AR acuity 1.18 the risk of aneurysm rupture is AR < 1.18 11.048 times,while the SR acuity 1.15 the risk of aneurysm rupture is the SR < 1.15 to 1.15 times.Conclusions(1)By CTA and DSA,to measure the morphological parameters of the unruptured aneurysms can indirectly predict and evaluate unruptured aneurysms rupture risk.(2)Caused by small aneurysms and aneurysms ruptured intracranial aneurysm occupies a lot in clinical in the proportion(34.5%).(3)Those aneurysm size parameters H,L,W and the dynamic pulse of intracerebral aneurysms rupture has a statistically significant difference,but we can not only to predict risk of aneurysm rupture,more can’t accurate tiny aneurysm and small aneurysm.(4)Wn,H,AR,L,SR,W,BN can be used as a review by the parameters of the risk of aneurysm rupture,was positively correlation with aneurysm rupture,the study of the SR,AR threshold is not contradiction,generally consistent with the literature.