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Size Ratio: A Morphological Factor Predictive of the Rupture of Cerebral Aneurysm?

Published online by Cambridge University Press:  23 September 2014

Meihua Li ,
Zhiqun Jiang ,
Huiqiang Yu  and
Tao Hong
Meihua Li*
Affiliation:
Department of Neurosurgery, First Affiliated Hospital of Nanchang University
Zhiqun Jiang
Affiliation:
Department of Neurosurgery, First Affiliated Hospital of Nanchang University
Huiqiang Yu
Affiliation:
Department of Health, School of Public Health, Nanchang University, Nanchang, China
Tao Hong
Affiliation:
Department of Neurosurgery, First Affiliated Hospital of Nanchang University
*
Department of Neurosurgery, the First Affiliated Hospital of Nanchang University, No.17 Yongwaizhengjie, Nanchang 330006, Jiangxi, China. Email: limeihua2000@sina.com
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Abstract

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Background:

Determining factors predictive of the natural risk of rupture of cerebral aneurysms is difficult. We studied morphological factors associated with rupture in a study model of patients with mirror location intracranial aneurysms, one aneurysm that had ruptured and one that had not, each patient served as their own control attempting to eliminate confounding variables.

Methods:

We collected five one-dimensional measurements and four two-dimensional indices from three-dimensional rotational digital subtraction angiography images of patients in the proposed study model and explored their correlation with aneurysm rupture. Parameters were analyzed with a paired Student's t test for significance and significant parameters were further examined by multivariate conditional logistic regression analysis.

Results:

Fifty-two patients with 52 pairs of intracranial aneurysms in a mirror location were studied. The maximum perpendicular height, neck diameter, maximum width, maximum height, aspect ratio, size ratio, and bottleneck factor were significantly associated with ruptured aneurysms on bivariate analysis. A logistic regression analysis showed that only size ratio, which was defined as the ratio of the maximal height to parent artery average diameter, is independently correlated with ruptured intracranial aneurysms.

Conclusions:

In a case-control study of patients with mirror location intracranial aneurysms, size ratio was identified as the unique morphological factor associate with the rupture of cerebral aneurysms.

Résumé:

Résumé:Contexte:

Il est difficile de déterminer les facteurs de prédiction du risque naturel de rupture des anévrismes cérébraux. Afin de tenter d'éliminer les variables confondantes, nous avons étudié les facteurs morphologiques associés à leur rupture chez des patients porteurs d'anévrismes intracrâniens symétriques, en miroir, dont un anévrisme qui s'était rompu et l'autre non, et chaque patient était son propre témoin.

Méthode:

Nous avons recueilli 5 mesures unidimensionnelles et 4 indices bidimensionnels d'images angiographiques par soustraction digitale rotatoire 3D chez ces patients et nous avons examiné leur corrélation à la rupture d'anévrismes. Les données pairées ont été analysés au moyen du test de student et les paramètres dont la valeur statistique était significative ontété examinés par une analyse de régression logistique conditionnelle multivariée.

Résultats:

Cinquante-deux patients porteurs de 52 paires d'anévrismes intracrâniens localisés en miroir ont été étudiés. À l'analyse bivariée, la hauteur perpendiculaire maximale, le diamètre du col, la largeur maximale, la hauteur maximale, le rapport hauteur/largeur, le rapport de taille et le facteur goulot d'étranglement étaient associés de façon significative à la rupture des anévrisme. Une analyse de régression logistique a montré que seulement le rapport de taille défini comme étant le rapport de la hauteur maximale au diamètre moyen de l'artère hôte était corrélé de façon indépendante à la rupture des anévrismes intracrâniens.

Conclusions:

Dans cette étude castémoin de patients porteurs d'anévrismes intracrâniens symétriques, en miroir, le rapport de taille a été identifié comme étant le seul facteur morphologique associé à la rupture des anévrismes cérébraux.

Type
Research Article
Information
Canadian Journal of Neurological Sciences , Volume 40 , Issue 3 , May 2013 , pp. 366 - 371
Copyright
Copyright © The Canadian Journal of Neurological 2013

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