The Relationship Between The Risk Of Rupture And The Morphological Characteristics In Multiple Intracranial Aneurysms

Object:By compare the images of the ruptured and unruptured aneurysms in the CTA of the intracranial multiple aneurysms in patients with aneurysmal subarachnoid hemorrhage,such as the length,the maximum vertical height of the aneurysm,and so on.In the study,we wish to summary the morphological features of the ruptured aneurysms and to assess the risk of intracranial aneurysm rupture and to assist in a more reasonable treatment.Materials:We clected the clinical date of cases with multiple intracranial aneurysms received to China-Japan union hospital of Jilin University between Jan 2016 and Jan2018.All ruptured aneurysm of these patients can be identified.In the study,we included a total of 50 ruptured and 60 unruptured aneurysms.We collected the messages of the patients and the location ? the shape of aneurysms by the CTA.We can collected five one-dimensional parameters[length(L),maximum vertical height(H),width(W),neck diameter(D),the main diameter of the vessel(Dm)] and five two-dimensional parameters[aspect ratio(AR),size ratio(SR),bottleneck factor(BF),height/width ratio(HWR),neck parentartery ratio(NPR)].We can determine the optimal thresholds for these parameters by the receiver-operating characteristic analysis(ROC).We can look for the significance with rupture of the aneurysms by analyzed the parameters with univariate statistical analyses.Results:1.In the study,the number of women is 2.57 times that of men,the proportion of women is higher.2.The aneurysms located in the anterior communicating artery,middle cerebral artery and internal carotid artery account for 85.4% of the total.The aneurysms located in the anterior communicating artery are more likely to rupture,which is statistically significant.(P<0.05).3.The shape of the aneurysm has the significant difference between the ruptured and unruptured aneurysms.The irregular shape of the aneurysm has the most feasibility to rupture,the cone-shape of the aneurysm has the least feasibility to rupture.4.In the univariate statistical analyses,we found the significant differences in four one-dimensional parameters L,H,W,Dm and five two-dimensional parameters AR,SR,BF,HWR,NPR between the ruptured and unruptured aneurysms,but in multivariate logistic regression analysis,we found that the ruptured aneurysms only had the strongest correlation with the L.The optimal thresholds of L was 3.35 and the odds of the rupture about aneurysm can add by 4.361 times,when L increase a unit.Conclusion:1.In this study,female patients accounted for a large proportion.Quite a few patients had hypertension,smoking history and drinking history.2.The rupture of the aneurysm is closely related to the location of the aneurysm,and the aneurysm located in the anterior communicating artery is most prone to rupture.3.The morphology of the aneurysm is closely related to the rupture of the aneurysm,and the irregular morphologic aneurysm is more likely to rupture,while the cone-shape aneurysm tends to be stable.4.With the increase of the length of the aneurysm,the rupture risk of the aneurysm is increase.