医学
无症状的
放射科
颈内动脉
动脉瘤
单变量分析
心脏病学
人口
血管造影
计算机断层血管造影
多元分析
内科学
环境卫生
作者
Jianjian Zhang,Xiao Li,Bing Zhao,Jin Zhang,Jianrong Xu,Lingling Wang,Shenghao Ding,Xiangyu Liu,Jing Yan,Mahmud Mossa‐Basha,Xiaosheng Liu,Jieqing Wan,Huilin Zhao,Jianrong Xu,Chengcheng Zhu
标识
DOI:10.1136/neurintsurg-2020-016811
摘要
Background Intracranial aneurysms (IAs) are common in the population and current imaging-based rupture risk assessment needs to be refined. We aimed to use four-dimensional CT angiography (4D-CTA) to investigate the associations of irregular pulsation of IAs with conventional risk factors and the estimated rupture risk. Methods One hundred and five patients with 117 asymptomatic IAs underwent 4D-CTA. Geometric and morphologic parameters were measured and the presence of irregular pulsation (defined as a temporary focal protuberance ≥1 mm on more than three successive frames) was identified on 4D-CTA movies. One- and 5 year aneurysm rupture risk were estimated using UCAS and PHASES calculators. Univariate and multivariate analyses were performed to investigate the conventional risk factors associated with irregular pulsation. Results Irregular pulsation was observed in 41.0% (48/117) of IAs. Aneurysm size (OR=1.380, 95% CI 1.165 to 1.634), irregular shape (OR=3.737, 95% CI 1.108 to 12.608), and internal carotid artery location (OR=0.151, 95% CI 0.056 to 0.403) were independently associated with irregular pulsation (P<0.05). Aneurysms with irregular pulsation had more than a 6-fold higher estimated rupture risk (1- and 5-year risk [95% CI], 1.56% [0.42%–3.91%], and 2.40% [1.30%–4.30%], respectively) than aneurysms without irregular pulsation (0.23% [0.14%–0.78%] and 0.40% [0.40%–1.30%], respectively) (P<0.001). Conclusions IAs with irregular pulsation are associated with larger size, irregular-shape, and non-ICA origin, and have more than a 6-fold higher estimated 1- and 5-year rupture risk than aneurysms without irregular pulsation. Irregular pulsation should be validated in future longitudinal studies to determine its predictive value for aneurysm growth and rupture.
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