Correlation Study Of Internal Carotid Artery Tortuosity And The Formation Or Rupture Of Anterior Circulation Intracranial Aneurysm Based On CTA Imaging

Objective(1)Based on head and neck CT angiography(computed tomography angiography,CTA)to analyze the correlation between the tortuosity degree of the internal carotid artery(ICA)and the formation of intracranial aneurysm(IA)in the anterior circulation.(2)Based on the morphological parameters of anterior circulation IA,the correlation between tortuosity degree of the ICA and the rupture of IA in the anterior circulation.Methods(1)To retrospectively analyze the clinical and imaging data of 163 patients diagnosed with anterior circulation IA by head and neck CTA,and include them in the case group;retrospectively analyze the clinical and imaging data of 158 patients with no IA confirmed by head and neck CTA,and include them Control group.Based on the head and neck CTA,both subjective evaluation and objective quantification are used to determine the degree of tortuosity of the patient’s ICA.The subjective evaluation method divides the degree of ICA into four types: normal,simple tortuosity,kink,and coil;the objective quantification method uses the extracranial internal carotid artery(EICA)tortuosity index(TI),ICA angle and common carotid artery(CCA)TI determine the degree of ICA tortuosity.First,univariate analysis of the risk factors for the formation of anterior circulation IA;secondly,compare the correlation between subjective evaluation and objective quantification;finally,the use of multivariate Logistic analysis to explore the independent risk factors for the formation of anterior circulation IA.(2)The 163 patients with anterior circulation IA were divided into ruptured group(57 cases)and unruptured group(106 cases)according to whether rupture occurred.Based on the head and neck CTA to measure the morphological parameters of all IA: IA length neck(L),IA height(H),tumor neck diameter(D),the ratio of L to the average diameter of the IA tumor artery(size ratio,SR),the ratio of H to D(aspect ratio,AR),angle of flow inflow(FA),IA inclination angle;determine the location and form of IA: ICA,anterior communicating artery(ACOA),anterior cerebral artery,middle cerebral artery.First,univariate analysis of the risk factors for rupture of anterior circulation IA;secondly,analysis of the correlation between the degree of ICA tortuosity and IA morphological parameters;finally,the use of multivariate Logistic analysis to explore the independent risk factors of rupture of anterior circulation IA.Results(1)The results of univariate analysis showed that the difference in female,ICA kink,ICA coil,EICA TI,ICA angle was statistically significant(P<0.05),which is a risk factor for the formation of anterior circulation IA,and the history of aspirin use is anterior circulation IA formation of protective factors(P<0.05);Spearman correlation analysis results of subjective evaluation method and objective quantification method show that subjective evaluation method and EICA TI are correlated(P<0.05);subjective evaluation method multivariate Logistic analysis results show that,female(OR=0.425,95%CI=0.249-0.723,P<0.05),ICA kink(OR=2.184,95%CI=1.204-3.962,P<0.05)are independent risk factors for the formation of anterior circulation IA,aspirin taking history(OR=9.886,95%CI=5.593-17.473,P<0.05)is a independent protective factor for the formation of anterior circulation IA;the results of multivariate Logistic analysis of objective quantification method showed that female(OR=0.395,95%CI=0.219-0.712,P<0.05),EICA TI(OR=1.073,95%CI=1.045-1.103,P<0.05),ICA angle(OR=1.058,95%CI=1.029-1.087,P<0.05)are the anterior circulation independent risk factor for the formation of IA,aspirin taking history(OR=8.326,95%CI=4.404-15.739,P<0.05)is a independent protective factor for the formation of IA.(2)Univariate analysis showed that gender,location(ICA,anterior communicating artery),ICA tortuosity(ICA normal,ICA simple tortuosity,ICA kink),EICA TI,morphological parameters(FA,H,AR,L,SR)were statistically significant(P<0.05),which were risk factors for anterior circulation IA rupture;independent sample non-parametric test analysis results show that the degree of ICA tortuosity of the subjective evaluation method is correlated with FA and SR(P<0.05);Spearman correlation analysis results show that the EICA TI and SR in the objective quantitative method H and L are correlated(P<0.05),EICA is correlated with FA,L(P<0.05),and ICA angle is not correlated with IA morphological parameters(P>0.05);multiple factors of subjective evaluation method Logistic analysis showed that FA(OR=1.055,95%CI=1.029-1.082,P<0.05),SR(OR=6.274,95%CI=2.357-16.699,P<0.05),ICA kink(OR=7.515,95%CI=2.839-19.894,P<0.05)was an independent risk factor for rupture of anterior circulation IA.The multivariate Logistic analysis result of objective quantification method showed that FA(OR=1.075,95%CI=1.045-1.106,P<0.05),SR(OR=6.244,95%CI=1.979-19.701,P<0.05),EICA TI(OR=1.037,95%CI=1.009-1.066,P<0.05)was an independent risk factor for IA rupture in the anterior circulation.Conclusions(1)EICA TI in the subjective evaluation method and the objective quantification method is an independent risk factor for the formation of anterior circulation IA,and the two evaluation methods are related.In addition,female and ICA angle are independent risk factors for the formation of anterior circulation IA,and aspirin taking history is a independent protective factor for the formation of anterior circulation IA.(2)The degree of ICA tortuosity determined by the subjective evaluation method,the EICA TI and CCA TI in the objective quantification method are related to the morphological parameters of the anterior circulation IA.In addition,FA,SR,ICA kink,and ECIA TI are independent risk factors for the rupture of anterior circulation IA.