Prediction Of Ruptured Intracranial Saccular Aneurysm Based On CTA Technology

Objective:The application of CTA technology can clearly and accurately display the morphological characteristics of ruptured and unruptured intracranial aneurysms,combined with clinical epidemiological parameters,in order to comprehensively assess the prediction of aneurysm rupture,early treatment and intervention,and improve the cure rate.Methods:A total of 126 patients with intracranial saccular aneurysms who were diagnosed with intracranial saccular aneurysms in the University of Chinese Academy of Sciences-Shenzhen Hospital from May 2016 to November 2021 were collected,including 48 in the ruptured group and 78 in the unruptured group.Observation of aneurysm surface morphology: mound-like protrusions,papillary protrusions,spine-like protrusions,smooth;CTA was used to measure aneurysm size,including aneurysm long diameter,aneurysm neck width,aneurysm width,aneurysm expansion height,and parent artery Diameter and incident angle,and calculate the ratio of aneurysm long diameter to aneurysm neck width,aneurysm neck width to parent artery diameter,expansion height to parent artery diameter,expansion height to aneurysm neck width,aneurysm long diameter to parent artery diameter,and the ratio of aneurysm length to tumor width;the clinical data of saccular aneurysm were recorded,and the above prediction factors were analyzed by univariate analysis and multivariate Logistic regression analysis.Results:There were 126 cases of saccular aneurysm in this paper,48 cases were ruptured group and 78 cases were unruptured group.There were significant differences in age,hypertension and diabetes history between the two groups(P<0.05),and the number of cases of hypertension and diabetes history is small,the statistical significance may be biased;but no statistical difference in gender and smoking history(P>0.05).The incidence rate of ruptured anterior communicating artery aneurysm group was significantly higher than that of unruptured group,and the difference was statistically significant(P<0.001).The incidence of internal carotid artery and basilar artery aneurysms in the unruptured group was significantly higher than that in the ruptured group(P< 0.05),but no statistical difference in posterior cerebral artery(P closed to0.05).There was no significant difference in the incidence of anterior cerebral artery,middle cerebral artery and posterior communicating artery aneurysms(P>0.05).The aneurysm length,aneurysm width,aneurysm expansion height,and incident angle between the ruptured group and the unruptured group were tested by independent samples t test,and the P values were all less than 0.05,and the difference was statistically significant.The ratio of aneurysm long diameter to aneurysm neck width,aneurysm neck width to parent artery diameter,expansion height to parent artery diameter,expansion height to aneurysm neck width,and aneurysm long diameter to parent artery between ruptured and unruptured groups,by statistical analysis,the P values were all less than 0.05,and the difference was statistically significant.The proportion of spines in the ruptured group(47.9%)was significantly higher than that in the unruptured group(7.7%);That the proportion of smooth surfaces in the unruptured group(74.4%)was significantly higher than that in the ruptured group(18.8%),had statistically difference showed by Chi square test(P< 0.001).In the above univariate analysis,the parameter P<0.05 was the independent variable and whether the aneurysm was ruptured was the dependent variable,showing that age(OR: 1.127,95%CI: 1.057-1.200,P=0.000),incidence angle(OR: 0.964,95%CI: 0.939-0.990,P=0.008),the spinous process in the surface morphology of aneurysm(OR: 10.3431,95%CI: 2.076-51.526,P=0.004)was an independent prediction factor for aneurysm rupture.ROC curve analysis of three independent risk factors for aneurysm rupture,including age,incidence angle and spinous process,showed that the AUC of the spinous process was 0.790,95%CI: 0.705 to 0.874,and the highest prediction accuracy among the independent prediction factors for aneurysm rupture,the more spines there are,the higher the prediction of aneurysm rupture;and that the best predictable value of the incidence angle was ≥110.5°(AUC0.650,95%CI: 0.541 to 0.759),the greater the angle of incidence,the higher the risk of aneurysm rupture;and that the best predictable value of the age was ≤53.5 years(AUC 0.247,95%CI: 0.166 to 0.333),the younger the age,the higher the risk of aneurysm rupture,but AUC 0.247<0.5,showed the lower the prediction accuracy.Conclusion:Patient age,hypertension,history of diabetes,location(anterior communicating artery,internal carotid artery),surface morphology(spinous,smooth),aneurysm long diameter,aneurysm width,aneurysm expansion height,incidence angle,the ratio of aneurysm long diameter to aneurysm neck width,aneurysm neck width to parent artery diameter,expansion height to parent artery diameter,expansion height to aneurysm neck width,aneurysm long diameter to parent artery diameter is related to the rupture of intracranial saccular aneurysm.Angle of incidence,spinous processes and age are independent prediction factors for rupture of intracranial saccular aneurysms.