Predictive value of size ratio of aneurysm deep to carrier artery diameter in rupture of very small (≤3 mm) anterior communicating artery aneurysms
10.3760/cma.j.issn.1671-8925.2018.12.006
- VernacularTitle:最大瘤体瘤深/载瘤动脉直径对前交通动脉微小动脉瘤破裂的预测价值
- Author:
Lifang CHEN
1
;
Yongchun CHEN
;
Jiafeng ZHOU
;
Boli LIN
;
Dingpin HUANG
;
Yunjun YANG
Author Information
1. 温州医科大学附属第一医院放射科
- Keywords:
Intracranial aneurysm;
Anterior communicating artery;
Very small aneurysm;
Rupture;
Morphology
- From:
Chinese Journal of Neuromedicine
2018;17(12):1221-1226
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the morphological factors related to the rupture of very small (≤3mm) anterior communicating artery (AComA) aneurysms, which provides basis for decision-making of whether or not taking intervention in very small un-ruptured AComA aneurysms. Methods (1) One hundred patients with primary AComA aneurysms, admitted to our hospital from January 2008 to June 2013, were enrolled; 84 AComA aneurysms were ruptured while 16 were un-ruptured; the morphological parameters of aneurysms were obtained by three-dimensional reconstruction with CT angiography (CTA) of the patients, and the clinical data and aneurysm morphological parameters were compared between the ruptured aneurysm group and the un-ruptured aneurysm group; multivariate Logistic regression was used to analyze the risk factors of small aneurysm rupture in the AComA, and receiver operating characteristic (ROC) curve was used to analyze the predictive efficacy of size ratio (SR) of maximum tumor depth to proximal carrier artery diameter in rupture of small aneurysms in the AComA. (2) Ninety-nine patients with primary AComA aneurysms, admitted to our hospital from June 2013 to January 2016, were enrolled; the parameters from the above analyses were applied to these patients to verify their predictive effectiveness. Results (1) Perpendicular height, AR value (Height/Neck), SR value and vessel angle were significantly different between ruptured aneurysm group and un-ruptured aneurysm group (P<0.05); multivariate Logistic analysis indicated that SR value was the independent risk factor of rupture of very small AComA aneurysms (OR=4.201, 95％CI: 1.175-15.019, P=0.012), and the lager the SR value, the higher the risk of rupture; ROC curve analysis revealed that the area under the curve was 0.699 with the optimal cut-off value being 0.9, and its diagnostic sensitivity, specificity and accuracy was 0.786, 0.625 and 0.760, respectively. (2) The SR value was then applied to the 99 patients, showing a stable predictive potential with sensitivity, specificity and accuracy of 0.676, 0.714 and 0.687, respectively. Conclusion SR value (≥0.9) is identified as independent morphological risk factor for rupture of very small AComA aneurysms; SR value is closely related to the state of aneurysms, which help make a better individualized and effective decision on the treatment of very small AComA aneurysms in clinic.
