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Analysis of the Risk Factors of Formation and Rupture in Intracranial Aneurysm on CTA Technology

Author: LiZiCong
Tutor: HuangJianQiang; HanDan
Course: Medical Imaging and Nuclear Medicine
Keywords: CTA(Computed Tomography Angiography) IA(Intracranial Aneurysm) Daughter bleb Morphological characteristic Aspect ratio Size ratio
CLC: R651.12
Type: Master's thesis
Year: 2012
Downloads: 85
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Objective:To explore the occurrence relationship between the formation of intracranial arterial aneurysm and the rupture risk of intracranial arterial aneurysm and the form of intracranial parent artery and intracranial arterial aneurysm, By CTA imaging techniques. Materials and methods:Retrospectively Collected500CTA subjects from march2009to march2012in the First Affiliated Hospital of Kunming Medical University, make the statistical analysis all of saccular intracranial aneurysm patient’s age, gender, smoking history, family history, and the circle of Willis type, obtained the results of occurrence analysis between the formation of intracranial saccular arterial aneurysms and These indicators; extracted cystic aneurysm from the previously mentioned intracranial saccular arterial aneurysm, and in accordance with whether it contains any form of separation of daughter blebs. According to the clinical manifestations suggestive or subarachnoid hemorrhage found in CT, and divided all cystic intracranial aneurysm into ruptured and unrupture group, we make the statistical analysis by Siemens dual-source CT computer software (MMWP) which showing the location of the saccular aneurysm and daughter blebs of all saccular cystic intracranial aneurysm. And measurement of aneurysm height, aneurysm width, aneurysm neck length, aneurysm parent arterial diameter, calculate the aspect ratio (AR), size ratio (SR), the analysis the relationship between all the indicators and the risk of rupture. Results1.The occurrence of intracranial aneurysms:classified as anterior circulation group with251people, posterior circulation group with52people and non-aneurysm group with197people.2.there is not statistically significant between the formation of saccular intracranial aneurysms and gender.3.A11subjects were9-88years old,52.6±5.8years, in which saccular intracranial aneurysm patients ranged in age9-88years old, mean age50.5±8.7years, the group of30-60years old was the prone age of saccular intracranial aneurysms.4.All subjects classified as smoking group with312people and non-smoking group with188people. The saccular intracranial aneurysm in smokers with213cases and the saccular intracranial aneurysm in non-smokers with90cases, there have significant difference between smoking and the formation of saccular intracranial aneurysms, smokers have an increased risk of saccular intracranial aneurysm.5.there is a close relationship between saccular intracranial aneurysms and family history of intracranial aneurysm, the subjects of family history have an increased risk of saccular intracranial aneurysm.6.there is important relationship between the variation of circle of Willis and the formation of intracranial aneurysm, the aneurysm in Anterior circulation prone to occurs in the circle of Willis type I, II, the aneurysm in posterior circulation can only be that type I, II on the circle of Willis prone than the type III, there is no significant difference between type I, type II, type IV.7.saccular cystic intracranial aneurysms for a total of288cases including31cases of saccular aneurysms with daughter bleb,257cases including saccular aneurysm without daughter bleb. saccular saccular aneurysm with daughter bleb has a high risk of rupture compared with the saccular saccular aneurysm without daughter bleb.8.It has statistically significant between the size of saccular saccular aneurysm and the risk of rupture, the group of<3mm size aneurysm and the group of3-10mm size of the aneurysm compared with the group of>10mm size of the aneurysm prone to rupture, there was not statistically significant between the group of<3mm size aneurysm and the group of3-10mm size aneurysm.9.According to the independent sample t-test analysis, there was statistically significant between AR, SR, and the risk of rupture with the saccular cystic intracranial aneurysm.10.According to logistic regression analysis derived the arterial diameter of aneurysm, aneurysm width, and the AR value was independently correlated with the risk of rupture, and we have the establishment of the mathematical model of risk assessment.Conclusion1.the group of30-60years old was the prone age of saccular intracranial aneurysms, there is no significant difference between the occurrence of aneurysms and gender.2.Smoking was the important risk factors for the formation of intracranial aneurysms.3. Family history was the important risk factors for the formation of intracranial aneurysms.4.there had statistically significant between saccular intracranial aneurysm of the anterior and posterior circulation and the circle of Willis variation types.This may be related to differences of individual existence.5.The presence of daughter bleb is an important risk factor for ruptured intracranial aneurysms,our results shows that intracranial aneurysms with daughter bleb prone to ruptured compared with intracranial aneurysms without daughter bleb, but the specific hemodynamic analysis has yet to the next study.6.there is statistically significant between single saccular IA size and risk of ruptured.7. AR and SR value were independent of the aneurysms distribution site impact, on behalf of the aneurysm, a good indicator of hemodynamic, arterial aneurysm rupture risk significantly increased with AR, SR values increased.8. the above indicators are better for the clinical prediction of the risk of rupture; preliminary mathematical model established in the multivariate logistic regression analysis pointed out that the AR value, the width of the aneurysm and the diameter of the aneurysm aneurysm aneurysm rupture independently associated with risk factors.the former two were risk factors, the greater value of intracranial aneurysm have the higher risk to rupture, on the contrary, the latter was a protective factor.

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