The value of CT angiography in risk factor assessment of intracranial aneurysm rupture / 中国医师杂志

ABSTRACT

Objective:To evaluate the value of CT angiography (CTA) in the assessment of risk factors for rupture of intracranial aneurysm (IA).Methods:The clinical and CT imaging data of 46 patients with IA in the Second Affiliated Hospital of Bengbu Medical College from January 2018 to June 2020 were retrospectively analyzed. The morphological parameters of aneurysm were analyzed by CTA post-processing images aneurysm number, site, morphology, maximum diameter, height/neck width, maximum diameter/parent artery proximal diameter, aneurysm incidence angle. The morphological risk factors of aneurysm rupture were evaluated by univariate analysis and multivariate logistic regression analysis. We used receiver operating characteristics curve (ROC) to evaluate the diagnostic efficacy in predicting aneurysm rupture.Results:A total of 58 aneurysms were detected by CTA, 30 ruptured aneurysms and 28 unruptured aneurysms. There was no statistically significant difference in gender and age between patients with ruptured and unruptured aneurysms ( P>0.05). In the morphological parameters of ruptured and unruptured aneurysms, there were no statistically significant differences in the number, site and height/neck width of aneurysms ( P>0.05), while there were statistically significant differences in aneurysm morphology, maximum diameter, maximum diameter/parent artery proximal diameter and aneurysm incidence angle ( P<0.05). Multivariate logistic regression analysis showed that maximum diameter/parent artery proximal diameter and aneurysm incidence angle were independent risk factors for aneurysm rupture ( P<0.05). ROC curve analysis showed that when the maximum diameter of the tumor / the diameter of the proximal carrying artery >1.985, the area under the curve was 0.748, and the sensitivity and specificity were 76.7% and 64.3%, respectively; When the incidence angle of blood flow was >117.5°, the area under the curve was 0.673, and the sensitivity and specificity were 53.3% and 75.0% respectively. Conclusions:The maximum diameter/parent artery proximal diameter >1.985 and the aneurysm incidence angle >117.5° are independent risk factors for aneurysm rupture.