摘要
目的:探讨颅内动脉瘤与血流动力学改变之间的关系。方法:回顾性分析2006年3月至2009年6月514例住院患者的数字减影血管造影(DSA)影像资料。全部病例均行双侧颈内动脉及椎-基底动脉造影,通过DSA影像学资料分析颅内动脉瘤与先天解剖特点引起的血流动力学改变之间的关系。结果:①514例住院患者中颅内动脉瘤191例,其中共含动脉瘤200个;其他脑血管病323例,分别为脑动-静脉畸形、烟雾病、硬脑膜动-静脉瘘、颈动脉海绵窦瘘、颅内血管狭窄及其他疾病,或DSA正常。②发现先天解剖特点造成血流动力学改变的颅内血管281支,其中颅内动脉瘤167支,其他脑血管病114支;颅内动脉瘤中85/200个(42.5%)动脉瘤伴有与之相关的血流动力学改变。③前交通动脉瘤中41/56例(73.2%)合并A1优势征,OR值为10.43(95%CI:5.52～19.72),差异有统计学意义(P<0.05);后交通动脉瘤中颈动脉供血型或混合供血型27/46例(58.7%),OR值为11.43(95%CI:6.15-21.26),差异有统计学意义(P<0.05)。结论:血流动力学改变是颅内动脉瘤形成的重要因素;A1优势征对前交通动脉瘤形成、Willis后环血流动力学改变对后交通动脉瘤形成具有重要意义。
Aim：To study the relationship between intracranial aneurysms and hemodynamic change by digital subtraction angiography.Methods：Cerebral angiographic findings in 514 patients who were admitted from March 2007 to June 2010 were retrospectively analyzed.All cases were screened by bilateral internal carotid artery and vertebrobasilar artery angiography.Relationship between intracranial aneurysms and hemodynamic change due to congenital vascular variation was evaluated by radiological data of digital subtraction angiography. Results：①191 cases were intracranial aneurysms containing 200 aneurysms in total.323 cases in control group were brain arteriovenous malformations,moyamoya disease,dural arteriovenous fistula,carotid cavernous fistula, intracranial artery stenosis,other cerebrovascular diseases and normal cerebral angiography.②281 intracranial vessels were found to have hemodynamic change caused by congenital vascular anatomy,including 167 vessels in intracranial aneurysm group and 114 vessels in the control group.Among of 200 intracranial aneurysms,85 （42.5%） were related with hemodynamic change.③Among of 56 anterior communicating aneurysms（AcoAs）, 41（73.21%） were companied with Al dominant sign.Odds ratio was 10.43（95%CI：5.52-19.72）.There was statistically significant difference（P0.05）.Among 46 posterior communicating aneurysms（PcoAs）,27（58.69%） were found to be supplied by internal carotid artery or mixed blood.Odds ratio was 11.43（95%CI：6.15-21.26）. There was also statistically significant difference（P0.05）.Conclusion：Hemodynamic change is an important factor for the formation of intracranial aneurysms.Al dominant sign and hemodynamic change of the posterior circle of Willis are respectively of great significance to the formation of anterior communicating aneurysms and posterior communicating aneurysms.
出处
《中国临床神经科学》
2011年第2期116-120,共5页
Chinese Journal of Clinical Neurosciences
基金
国家自然科学基金资助项目(编号:30700864)
