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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。结果破裂组瘤体长度(4.95±4.80)mm,平均瘤颈宽度(3.55±3.10)mm,平均AR值(1.21±0.68),47.6%有子囊;未破裂组瘤体长度(2.75±2.65)mm,平均瘤颈宽度(2.85±1.90)mm,平均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、3.35 mm和1.135;瘤颈宽度<3.35 mm时的破裂风险是>3.35 mm时的2.05倍,瘤体长度>3.65 mm时的破裂风险是<3.65 mm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。
Objective To study the relationship between the morphological features of intracranial aneurysms and the risk of rupture and to predict the risk of aneurysm rupture. Methods Retrospective analysis of 154 cases of 194 intracranial aneurysms, including 61 cases of rupture (82 aneurysms) and 93 cases of non-rupture (112 aneurysms), the length of the tumor and neck width were measured, and the tumor Length and tumor neck width ratio (AR value), to observe the availability of ascus, ascocyclus number and location, analysis of the above indicators and rupture correlation. Results The length of tumor in rupture group was 4.95 ± 4.80 mm and the average tumor width was 3.55 ± 3.10 mm. The mean AR value was 1.21 ± 0.68 and 47.6% , Mean tumor width (2.85 ± 1.90) mm, mean AR value (0.96 ± 0.55) and 14.3% with ascus. The difference between the two groups with or without ascus was statistically significant (P <0.05). The critical tumor length, tumor neck width and AR value of ruptured intracranial aneurysms were 3.65, 3.35 mm and 1.135, respectively. The risk of rupture when tumor width was 3.35 mm was 2.05 times that of 3.35 mm and tumor length was 3.65 mm, the risk of rupture at 3.65 mm was 3.76 times greater than that at <3.65 mm, the risk of rupture was 3.18 at <1.135 with an AR value of 1.135, and 5.64 times the risk of rupture with ascus. Conclusions The tumor length, tumor neck width, AR value and ascochlea formation of intracranial aneurysm are the risk factors for aneurysm rupture. The longer the tumor, the smaller the tumor neck, the larger the AR value or the formation of ascapsids and the risk of aneurysm rupture The bigger