Morphological and Hemodynamic Discriminators for Rupture Status in Posterior Communicating Artery Aneurysms.
Morphological and Hemodynamic Discriminators for Rupture Status in Posterior Communicating Artery Aneurysms.
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后交通动脉瘤破裂状态的形态学和血流动力学鉴别因素
DOI：
10.1371/journal.pone.0149906
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Huang Q
中科院分区：
文献类型：
--
作者：
Lv N;Wang C;Karmonik C;Fang Y;Xu J;Yu Y;Cao W;Liu J;Huang Q
背景和目的先前关于颅内动脉瘤破裂的形态学和血流动力学研究结果相互矛盾，可能是由于样本量相对较小以及患者特异性动脉瘤模型的位置变化造成的。我们的目的是通过仅关注后交通动脉（PCoA）动脉瘤来确定动脉瘤破裂状态的鉴别因素。材料和方法 在 129 例 PCoA 动脉瘤（85 例破裂，44 例未破裂）中，比较破裂和未破裂病例的临床、形态和血流动力学特征。进行多变量逻辑回归分析以确定 PCoA 动脉瘤破裂状态的鉴别因素。结果单变量分析显示，动脉瘤圆顶大小、纵横比（AR）、尺寸比（SR）、圆顶与颈比（DN）、流入角（IA）、归一化壁剪应力（NWSS）和低壁剪应力区域百分比（LSA）与PCoA动脉瘤破裂状态显着相关。通过多变量分析，只有较高的 IA（OR = 1.539，p < 0.001）和 LSA（OR = 1.393，p = 0.041）才保留显着性。结论 血流动力学和形态学与颅内动脉瘤破裂状态相关。较高的 IA 和 LSA 被确定为 PCoA 动脉瘤破裂状态的鉴别因素。
Background and Purpose The conflicting findings of previous morphological and hemodynamic studies on intracranial aneurysm rupture may be caused by the relatively small sample sizes and the variation in location of the patient-specific aneurysm models. We aimed to determine the discriminators for aneurysm rupture status by focusing on only posterior communicating artery (PCoA) aneurysms. Materials and Methods In 129 PCoA aneurysms (85 ruptured, 44 unruptured), clinical, morphological and hemodynamic characteristics were compared between the ruptured and unruptured cases. Multivariate logistic regression analysis was performed to determine the discriminators for rupture status of PCoA aneurysms. Results While univariate analyses showed that the size of aneurysm dome, aspect ratio (AR), size ratio (SR), dome-to-neck ratio (DN), inflow angle (IA), normalized wall shear stress (NWSS) and percentage of low wall shear stress area (LSA) were significantly associated with PCoA aneurysm rupture status. With multivariate analyses, significance was only retained for higher IA (OR = 1.539, p < 0.001) and LSA (OR = 1.393, p = 0.041). Conclusions Hemodynamics and morphology were related to rupture status of intracranial aneurysms. Higher IA and LSA were identified as discriminators for rupture status of PCoA aneurysms.