临床,3D形态和血液动力学风险因素导致未破裂的内动脉瘤不稳定
Jiewen Geng1,2, Simin Wang1,2, Yadong Wang3
1Department of Neurosurgery, Beijing Xuanwu Hospital, Capital Medical University, 100053, Beijing, China.
Clinical neuroradiology
|June 15, 2023
概括
未破裂的内动脉瘤 (UIA) 可能变得不稳定. 控制不良的高血压和特定位置,如后部循环,增加了UIA的不稳定性风险. 对于高风险动脉瘤,密集监测或治疗至关重要.
科学领域:
- 神经外科 神经外科
- 放射学 放射学是一门学科.
- 血管神经学 血管神经学
背景情况:
- 未破裂的内动脉瘤 (UIA) 需要谨慎管理,因为随访期间的稳定性不确定.
- 识别UIA不稳定性 (破裂或生长) 的风险因素对于有效的患者护理至关重要.
研究的目的:
- 调查与UIA不稳定性相关的临床,形态和血液动力学风险因素.
- 为改善UIA的监测和治疗策略提供数据.
主要方法:
- 对263名患者的304个UIA进行了回顾性分析,其中6个月以上的飞行时间磁共振血管学 (TOF-MRA) 随访.
- 计算机辅助半自动测量 (CASAM) 用于动脉瘤生长评估和形态参数记录.
- 单变量和多变量考克斯回归分析,以确定不稳定性预测因子的危险比率.
主要成果:
- 动脉瘤的年增长率为4.7%.
- UIA不稳定性的显著预测因素包括控制不良的高血压 (HR 2.97),后部循环位置 (HR 7.81),后部通讯动脉 (HR 3.01),洞腔大动脉 (HR 3.78) 和尺寸比≥0.87 (HR 2.54).
结论:
- 控制高血压在治疗UIA方面至关重要.
- 后部通讯动脉,后部循环和洞穴性动脉中的动脉瘤需要加强监测或及时干预.
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