| Objective:The morphological characteristics of intracranial aneurysm diagnosed with digital subtraction angiography (DSA) were analyzed by the method of imaging anatomy. The variant morphological characters of intracranial aneurysm related to the treatment and recovery were further evaluated.Methods:The various position, shape, size and ratio of neck/body of intracranial aneurysm imaged with DSA in 30 cases in Jiuquan Hospital were measured and analyzed. The relationship between morphological characters of intracranial aneurysm and therapeutic method or recovery was evaluated.Results:1. General situation in patients with intracranial aneurysm:30 cases of intracranial aneurysm diagnosed by DSA were used to analyze with anatomic method. The ratio male and female patients with intracranial aneurysm was respectively 20:10 (P<0.05). In 30 cases diagnosed with intracranial aneurysm,27 cases of subarachnoid hemorrhage were significantly more than 3 cases of cerebral infarct (P<0.005).2. The morphological characters of intracranial aneurysm analyzed by imaging anatomy:(1) Location:In 30 cases with intracranial aneurysm,90% intracranial aneurysm located in internal carotid artery system and were more than that in vertebral artery system (10%, P<0.005). The intracranial aneurysm located in the anterior and middle cerebral artery was 56.7% and more than that in internal carotid-posterior communicating artery (23.3%) and located in vertebral-basic artery (10%), respectively (P<0.005).(2) Shape:Scrotiform in total aneurysm was 86.6% in which oval shape, hemisphere shape, pear-shaped and irregular-shaped respectively were 43.3%, 33.3%,6.6%and 3.3%. However, aortic dissection and fusiform aneurysm were respectively 10.0% and 3.3% and less than scrotiform (P<0.005)。(3) Size:The diameter of intracranial aneurysm in 5-10 mm,<5 mm and>10 mm respectively was 66.7%,22.2% and 11.1%(P<0.05 as compared with each other)。(4) The ratio of neck/body:The ratio of neck/body in>0.5 and<0.5 respectively was 55.6% and 44.4%(P>0.05).3. The relationship between morphological characters of intracranial aneurysm and therapeutic method or recovery:(1) The position of aneurysm located in the anterior and middle cerebral artery originating from internal carotid artery system treated by endovascular therapy or microsurgery was effective. The position of aneurysm located other part treated with endovascular therapy was the best choice. The recovery of patients treated with endovascular therapy or microsurgery were better than other therapeutic methods.(2) The various shapes of aneurysm treated by endovascular therapy were difference in degree of difficulty; in general, the sequence from easy to difficult was scrotiform, globular, dumbbell-form and irregularity-form. (3) The various size of aneurysm treated by endovascular therapy was also difference in degree of difficulty; in general, the diameter<5mm was much difficult to treat, and the diameter 5-10 mm and>10 mm were easily treated since a coil was formed as intravascular "basket" and led to a better stability.(4) The ratio of neck/body of intracranial aneurysm>0.5 was better recovery after endovascular therapy because of ease performance, in contrast,>0.5 was poor to recover after treatment.Conclusion:DSA is useful and effective method, which could be popularized in the Hospital at county level, for diagnosis of intracranial aneurysm, selection of therapeutic method and prediction of recovery. The results of imaging anatomical analysis on DAS for intracranial aneurysm suggest that endovascular therapy is most effective and safe ways to treat scrotiform and narrow neck aneurysm, and a selective way to treat dumbbell-form and irregularity-form aneurysm. Endovascular therapy for diameter 5-10mm or>10 mm intracranial aneurysm is more safety than diameter<5 mm intracranial aneurysm. The position of aneurysm located in carotid artery system and proximal segment is more easily blocked by endovascular therapy than that in vertebrobasilar system and distal segment. |
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