Morphologic and Hemodynamic Risk Factors in Ruptured Aneurysms Imaged before and after Rupture
Morphologic and Hemodynamic Risk Factors in Ruptured Aneurysms Imaged before and after Rupture
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DOI：
10.3174/ajnr.a4016
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发表时间：
2014-11-01
影响因子：
3.5
通讯作者：
Sayre, J.
中科院分区：
文献类型：
--
作者：
Chien, A.;Sayre, J.
背景和目的：由于有关动脉瘤自然史的信息有限，为未破裂动脉瘤选择适当的管理策略具有挑战性。通过比较未破裂和破裂的病例，研究已经确定了各种动脉瘤形态和血流动力学特性作为破裂的风险因素。在这项研究中，我们调查了4个破裂的动脉瘤破裂前和破裂后的变化，并测试是否以前发表的风险因素确定的风险前rupture.MATERIALS和METHODS：一个回顾性审查破裂的动脉瘤的基础上纳入标准的记录血管造影图像之前和破裂后进行。这种情况极为罕见。为了尽量减少位置对血流动力学的影响，我们选择了4例后交通动脉。应用三维形态学和血流动力学分析来检查动脉瘤破裂前后的定性和定量危险因素。体积，表面积和形态的变化，在高和低壁剪切应力区。动脉瘤表面比率，nonsphericity指数，脉动指数是唯一的风险因素，始终确定风险之前和之后的动脉瘤破裂为所有aneurysms.CONCLUSIONS：虽然形状和流动特性的变化，发现之前和之后的动脉瘤破裂，在这个小的研究，我们发现，一些危险因素是明显的，早在2年前破裂。
BACKGROUND AND PURPOSE: Due to limited information about aneurysm natural history, choosing the appropriate management strategy for an unruptured aneurysm is challenging. By comparing unruptured and ruptured cases, studies have identified a variety of aneurysm morphologic and hemodynamic properties as risk factors for rupture. In this study, we investigated changes in 4 ruptured aneurysms before and after rupture and tested whether previously published risk factors identified a risk before rupture.MATERIALS AND METHODS: A retrospective review of ruptured aneurysms based on the inclusion criteria of documenting angiographic images before and after rupture was performed. Such cases are extremely rare. To minimize hemodynamic influence due to location, we selected 4 cases at the posterior communicating artery. 3D morphologic and hemodynamic analyses were applied to examine qualitative and quantitative risk factors in aneurysms before and after rupture.RESULTS: When we compared aneurysms before and after rupture, all increased in size. Volume, surface area, and morphology changed in both high and low wall shear stress areas. Aneurysm surface ratio, nonsphericity index, and pulsatility index were the only risk factors to consistently identify risk before and after aneurysm rupture for all aneurysms.CONCLUSIONS: Although changes in shape and flow properties were found before and after aneurysm rupture, in this small study, we found that some risk factors were evident as early as 2 years before rupture.