Analysis of imaging anatomical features for the rupture of small intracranial aneurysms
Wang Tianyu1, Shi Weiyu1, Liu Junzhong1, Mao Liwu1, Guo Guangtao1, Zhao Lei1, Li Tianxiao2, He Yingkun2, Wang Shengjie1, Zhu Xiaochuan1, Xu Heng1
1Department of Neurointervention, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, China; 2Department of Cerebrovascular Interventional, Henan Provincial People's Hospital, Zhengzhou 450000, China
Abstract：Objective To explore the relationship between the rupture of small intracranial aneurysms and their anatomical features, and establish the prediction model for assessing the risk score of the rupture of aneurysms to provide references for the intervention of small intracranial aneurysms.Methods Data of 182 cases with small intracranial aneurysms were analyzed retrospectively, which was confirmed by computed tomography angiography or digital subtraction angiography in Zhengzhou Central Hospital Affiliated to Zhengzhou University from January 2015 to May 2020. In this study, 62 males and 120 females, aged 31-83 (56.85±11.51) years were included. The patients were divided into rupture aneurysm group (95 cases) and unruptured group (87 cases). Univariate analysis was used to analyze the clinical features and imaging anatomical data. Multivariate logistic regression analysis was used to analyze the independent risk factors for ruptured intracranial aneurysms, and the prediction model for assessing the risk score of aneurysm rupture was established.Results Univariate analysis showed that statistically significant differences in aneurysm location, morphology, asci of aneurysm, inflow angle, and aspect ratio(AR)value existed between the two groups (all P values＜0.05). Multivariate logistic regression analysis disclosed that asci of aneurysm, inflow angle＞117.75°, and AR value＞1.65 were the independent risk factors for the rupture of intracranial aneurysms (all P values＜0.01). The area under the receiver operator characteristic curve of aneurysm rupture risk score (R) based on the logistic prediction model was 0.812(95% confidence interval 0.750-0.874, P＜0.01), R=2 was the best cut-off value, sensitivity was 72.6%, and specificity was 78.2%.Conclusions Patients with small unruptured intracranial aneurysms have two or more imaging anatomical characteristics, such as aneurysm located in the posterior communicating segment of the internal carotid artery or anterior communicating artery, irregular shape, with capsule, inflow angle＞117.75°, and AR value＞1.65, are high-risk groups of aneurysm rupture.
王天玉, 时伟玉, 刘俊中, 毛立武, 郭广涛, 赵磊, 李天晓, 贺迎坤, 王圣杰, 祝晓川, 许恒. 影响颅内小型动脉瘤破裂的影像解剖特征分析[J]. 中华解剖与临床杂志, 2021, 26(3): 287-292.
Wang Tianyu, Shi Weiyu, Liu Junzhong, Mao Liwu, Guo Guangtao, Zhao Lei, Li Tianxiao, He Yingkun, Wang Shengjie, Zhu Xiaochuan, Xu Heng. Analysis of imaging anatomical features for the rupture of small intracranial aneurysms. Chinese Journal of Anatomy and Clinics, 2021, 26(3): 287-292.
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2021, Vol. 26 
