|
|
|
| Clinical and Imaging Risk Factors for Rupture of Multiple Intracranial Aneurysms |
| GUO Ran, XIN Ruiqiang, et al |
| Beijing Luhe Hospital, Capital Medical University, Beijing 101149, China |
|
|
|
|
Abstract Objective: To investigate the potential clinical and imaging risk factors for the rupture of multiple intracranial aneurysms.Methods: A retrospective analysis of the clinical and imaging data of patients with multiple intracranial aneurysms treated in our hospital from April 2013 to December 2021 was conducted. Patients were divided into rupture and non-rupture groups based on whether their aneurysms had ruptured. Univariate analysis was performed on the clinical and imaging parameters of both groups to identify statistically significant risk factors, which were then used as independent variables for further multivariate Logistic regression analysis to explore the risk factors influencing the rupture of multiple intracranial aneurysms.Results: Univariate regression analysis indicated significant differences between the rupture group (n=52) and the non-rupture group (n=85) in terms of age, gender, hypertension, hyperlipidemia, atherosclerotic diseases, maximum aneurysm diameter, width, aspect ratio, and aneurysm location (all P<0.05). Younger age was associated with a higher likelihood of rupture (P<0.05). The rupture group had significantly greater maximum diameter, width, and aspect ratio than the non-rupture group (P<0.05). Aneurysms located in the anterior communicating artery, posterior communicating artery, middle cerebral artery, and basilar artery had higher rupture rates compared to aneurysms in other locations (P<0.05). Multivariate Logistic regression analysis identified gender (OR=3.664, 95%CI): 1.577~8.515, P=0.003), maximum aneurysm diameter (OR=1.405, 95% CI: 1.130~1.747, P=0.002), and aneurysm location as independent risk factors for the rupture of multiple intracranial aneurysms. Specifically, aneurysms in the anterior communicating artery (OR=26.747, 95% CI: 5.384~132.883, P<0.001) and posterior communicating artery (OR=15.288, 95% CI: 3.659~63.885, P<0.001) had the highest risk of rupture. Hyperlipidemia was identified as an independent protective factor against the rupture of multiple intracranial aneurysms (OR=0.103, 95% CI: 0.026~0.405, P=0.001). Conclusion: Gender, maximum aneurysm diameter, and aneurysm location are independent risk factors for the rupture of multiple intracranial aneurysms, while hyperlipidemia is an independent protective factor. These findings provide crucial evidence for the development of personalized preventive strategies for unruptured aneurysms in patients with multiple intracranial aneurysms.
|
|
|
|
|
|
[1] Mirzat Turhon,Mengxing Li,Huibin Kang,et al.Development and validation of a deep learning model for prediction of intracranial aneurysm rupture risk based on multi-omics factor[J].Eur Radiol,2023,33(10):6759-6770.
[2] 陈建秋,徐峰,仇成丞,等.基于CTA分析颅内动脉瘤破裂危险因素的初步研究[J].中国CT和MRI杂志,2023,21(11):28-30.
[3] Ignacio KHD,Pascual JSG,Factor SJV,et al.A meta-analysis on the prevalence of anxiety and depression in patients with unruptured intracranial aneurysms:exposing critical treatment gaps[J].Neurosurg Rev,2022,45(3):2077-2085.
[4] 中国医师协会神经介入专业委员会,中国颅内动脉瘤计划研究组.颅内动脉瘤影像学判读专家共识[J].中国脑血管病杂志,2021,18(7):492-504.
[5] Fuentes AM,Stone McGuire L,Amin-Hanjani S.Sex differences in cerebral aneurysms and subarachnoid hemorrhage[J].Stroke,2022,53(2):624-633.
[6] 王阔,李曼曼,李彦良,梁爽.颅内动脉瘤影像学检查与破裂风险的研究现状[J].中国中西医结合影像学杂志,2023,21(2):206-210.
[7] Detmer FJ,Chung BJ,Jimenez C,et al.Associations of hemodynamics,morphology,and patient characteristics with aneurysm rupture stratified by aneurysm location[J].Neuroradiology.2019,61(3):275-284.
[8] Hostettler IC,Alg VS,Shahi N,et al.Characteristics of unruptured compared to ruptured intracranial aneurysms:a multicenter case-control study[J].Neurosurgery,2018,83(1):43-52.
[9] Zhang B,Dong S,Miao Y,et al.Effects of blood lipids and lipid-modifying drugs on intracranial aneurysms[J].Eur Neurol,2022,29(10):2967-2975. |
|
|
|
2024, Vol. 30 
