摘要
目的 了解 3种临床少见大脑动脉瘤及其动脉分叉的形态学特点.方法 纳入 2017年 1月至2020 年 4 月石家庄市人民医院收治的大脑前动脉-胼周动脉(ACA-PA)动脉瘤患者 8 例,颈内动脉-脉络膜前动脉(ICA-AChA)分叉动脉瘤患者 5 例,椎动脉-小脑后下动脉(VA-PICA)分叉动脉瘤患者 4 例.记录患者的临床基线资料并测量形态学参数.分叉顶角和小、大外侧角分别定义为φ1、φ2 和φ3,D1、S1 和T1 分别代表主干血管的直径、横截面面积和曲度;D2、S2 和T2 定义为与主干血管形成小外侧角一侧分支血管的相应参数;D3、S3 和T3 则为对侧分支血管的相对应形态学参数.结果 ICA-AChA和VA-PICA分叉动脉瘤均为D型动脉瘤,且朝向小外侧角;6 例患者的ACA-PA分叉动脉瘤为C型动脉瘤,其中 5 例患者的C型动脉瘤朝向小外侧角.ACA-PA和ICA-AChA动脉瘤患者的S2 和φ2 均显著小于S3 和φ3(P＜0.05),而T2 显著大于T3(P＜0.05);VA-PICA分叉动脉瘤亦具有相似趋势.结论 3 种动脉瘤多朝向小外侧角,且小外侧角及其同侧分支血管的直径、横截面面积均小于对侧,而曲度大于对侧分支血管.
Abstract
Objective To discuss the morphological characteristics of three types of clinically rare cerebral aneurysms and arterial bifurcations.Methods A total of 17 patients with clinically rare cerebral aneurysms,including anterior cerebral artery-pericallosal artery aneurysms(ACA-PA aneurysms,n=8),internal carotid artery-anterior choroidal artery bifurcation aneurysms(ICA-AChA aneurysms,n=5)and vertebral artery-posterior inferior cerebellar artery bifurcation aneurysms(VA-PICA aneurysms,n=4),who received treatment in the Shijiazhuang People's Hospital between January 2017 and April 2020 were enrolled in this study.The clinical baseline data were recorded,and the morphological parameters of the aneurysms were determined.The bifurcation angle,small lateral angle and large lateral angle were defined as φ1,φ2 and φ3,respectively.D1,S1 and T1 represented the diameter,cross-sectional area and tortuosity of the main blood vessel,respectively.D2,S2 and T2 were defined as the corresponding parameters of the branch vessel forming small lateral angle with the main vessel.D3,S3 and T3 were the corresponding morphological parameters of the contralateral branch vessel.Results All of the ICA-AChA and VA-PICA bifurcation aneurysms were type D aneurysms and oriented towards the small lateral angle.Six ACA-PA bifurcation aneurysms were type C aneurysm,and 5 of them were oriented toward the small lateral angle.The S2 and φ2 of the ACA-PA and ICA-AChA bifurcations harboring aneurysms were significantly smaller than S3 and φ3(P＜0.05),while T2 was remarkably largerthan T3(P＜0.05).The VA-PICA bifurcations also showed a similar manifestations.Conclusion These three types of clinically rare cerebral aneurysms are mostly oriented towards the small lateral angle,and the diameter and cross-section area of the branch forming small lateral angle with parent artery were smaller than those of the contralateral branch vessel,while the tortuosity was greater than that of the contralateral branch.
基金项目
河北省医学科学研究重点课题计划(20191459)
国家自然科学基金(81901184)
河北省重点研发计划项目(22377753D)
NETL
NSTL
万方数据