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目的利用64排螺旋CT血管成像(CTA),研究前交通动脉复合体变异类型与前交通动脉瘤(anteriorcommunicating aneurysms,ACoA)发病及破裂出血的相关性。资料与方法回顾性分析620例脑部CTA表现及临床资料,选取48例ACoA患者为研究组,121例无动脉瘤患者为对照组,分析A1段、前交通动脉影像表现及类型,比较ACoA发病、破裂出血与复合体变异、变异侧别的相关性。结果大脑前动脉A1段成窗畸形少见约3%,与ACoA发病无相关性。ACoA患者A1段变异发生率50%,对照组患者A1段变异发生率为31%,ACoA患者A1段变异发生率高于对照组,差异有显著统计学意义(χ2=5.12,P<0.05),存在明显左侧优势(χ2=7.79,P<0.01)。前交通动脉异常型发生率在ACoA患者中与对照组差异无统计学意义(χ2=0.72,P>0.05)。24例复合体变异的ACoA,动脉瘤破裂、蛛网膜下腔出血程度与复合体变异相关(Z=-2.63,P<0.05)。结论 CTA能清晰地显示前交通动脉复合体变异,前交通复合体变异与ACoA发病及破裂后出血严重程度相关。
Objective To study the relationship between the type of anterior communicating artery complex and the incidence of anterior communicating aneurysms (ACoA) and rupture of hemorrhage using 64-slice spiral CT angiography (CTA). Materials and Methods Retrospective analysis of 620 cases of brain CTA performance and clinical data, selected 48 cases of ACoA patients as study group, 121 cases of aneurysms as control group, analysis of A1 segment, anterior communicating artery imaging performance and type, compared ACoA incidence , Bleeding and complex rupture, mutation side of the other related. Results Alzheimer’s disease in A1 segment of anterior cerebral artery was about 3% rare, which was not associated with the onset of ACoA. The frequency of A1 segment mutation was 50% in ACoA patients and 31% in A1 patients in control group. The A1 segment mutation rate in ACoA patients was significantly higher than that in control group (χ2 = 5.12, P <0.05) There was a clear left superiority (χ2 = 7.79, P <0.01). The incidence of anterior communicating artery abnormalities in ACoA patients with no significant difference between the control group (χ2 = 0.72, P> 0.05). The ACoA, aneurysm rupture and subarachnoid hemorrhage in 24 patients with complex variation were associated with complex variation (Z = -2.63, P <0.05). Conclusion CTA can clearly show the variation of anterior communicating artery complex. The change of anterior traffic complex is related to the onset of ACoA and the severity of bleeding after rupture.