Hemodynamic and morphological characteristics of unruptured posterior communicating artery aneurysms with oculomotor nerve palsy
Hemodynamic and morphological characteristics of unruptured posterior communicating artery aneurysms with oculomotor nerve palsy
复制标题
未破裂后交通动脉瘤伴动眼神经麻痹的血流动力学和形态学特征。
DOI：
10.3171/2015.6.jns15267
复制
发表时间：
2016-08-01
影响因子：
4.1
通讯作者：
Huang, Qinghai
中科院分区：
文献类型：
--
作者：
Lv, Nan;Yu, Ying;Huang, Qinghai
目的：未破裂的后交通动脉（PCoA）动脉瘤合并动眼神经麻痹（ONP）有很高的破裂风险。本研究通过分析合并ONP的PCoA动脉瘤，探讨颅内高破裂风险动脉瘤的血流动力学和形态学特征。方法选取伴有ONP的未破裂PCoA动脉瘤14例，破裂PCoA动脉瘤33例，无症状未破裂PCoA动脉瘤21例。比较两组患者的临床、形态学和血流动力学特征。结果3组患者的临床特征差异无统计学意义（p < 0.05），但形态学和血流动力学分析显示，3组患者的大小、长径比、大小比、波动指数、非球性指数、椭圆性指数、归一化壁剪应力（WSS）、低WSS面积百分比差异有统计学意义（p < 0.05）。此外，多次比较显示，除大小外，这些参数在ONP组与无症状未破裂组、破裂组与无症状未破裂组之间存在显著差异（p = 0.0005）。在ONP组和破裂组之间没有形态学或血流动力学参数的差异。结论伴有ONP的未破裂PCoA动脉瘤表现出独特的形态-血流动力学模式，与无症状未破裂PCoA动脉瘤相比有显著差异，与破裂PCoA动脉瘤相似。PCoA动脉瘤体积较大，形状不规则，WSS较低，可能与动脉瘤破裂风险高有关。
OBJECT Unruptured posterior communicating artery (PCoA) aneurysms with oculomotor nerve palsy (ONP) have a very high risk of rupture. This study investigated the hemodynamic and morphological characteristics of intracranial aneurysms with high rupture risk by analyzing PCoA aneurysms with ONP. METHODS Fourteen unruptured PCoA aneurysms with ONP, 33 ruptured PCoA aneurysms, and 21 asymptomatic unruptured PCoA aneurysms were included in this study. The clinical, morphological, and hemodynamic characteristics were compared among the different groups. RESULTS The clinical characteristics did not differ among the 3 groups (p > 0.05), whereas the morphological and hemodynamic analyses showed that size, aspect ratio, size ratio, undulation index, nonsphericity index, ellipticity index, normalized wall shear stress (WSS), and percentage of low WSS area differed significantly (p < 0.05) among the 3 groups. Furthermore, multiple comparisons revealed that these parameters differed significantly between the ONP group and the asymptomatic unruptured group and between the ruptured group and the asymptomatic unruptured group, except for size, which differed significantly only between the ONP group and the asymptomatic unruptured group (p = 0.0005). No morphological or hemodynamic parameters differed between the ONP group and the ruptured group. CONCLUSIONS Unruptured PCoA aneurysms with ONP demonstrated a distinctive morphological-hemodynamic pattern that was significantly different compared with asymptomatic unruptured PCoA aneurysms and was similar to ruptured PCoA aneurysms. The larger size, more irregular shape, and lower WSS might be related to the high rupture risk of PCoA aneurysms.