Study On The Diagnosis And Risk Of Rupture Of The Intracranial Aneurysms By CT Angiography

Part1Comparative study of CTA and DSA in diagnosis of intracranial aneurysmsObjective:Assess the value of CTA in the diagnosis of intracranial aneurysms by comparative analysis of the imaging findings of CTA and DSA in it.Methods:A retrospective analysis was carried out on the clinical data of86hospitalized patients with subarachnoid hemorrhage during the period from January2010to December2012. There were42males and44females, aged25to77years old, with an average age of51.86±10.95years. Take the CTA and DSA examination after being admitted to hospital. Analyze the ability of CTA and DSA in the diagnosis of intracranial aneurysms, which were divided into different groups by location, shape and size.Result:In86patients with subarachnoid hemorrhage, we eventually confirmed81patients having intracranial aneurysms and found a total of95intracranial aneurisms. The sensitivity, specificity and accuracy of CTA in the diagnosis of intracranial aneurysms were94.7%,85.7%and94.1%.The sensitivity, specificity and accuracy of DSA were97.9%,83.3%and97.0%.Therefore, there was no significant differences(P>0.05) between CTA and DSA in the diagnosis of intracranial aneurysms. We made statistical analysis for aneurysms which were grouped by size (0～3mm,3～5mm,5～10mm, more than10mm). The results showed that,within each group, there was no significant difference (P>0.05) of the sensitivity, specificity and accuracy of CTA and DSA in the diagnosis of intracranial aneurysms. Similarly, there was no significant difference of the accuracy between CTA and DSA in the diagnosis of intracranial aneurysms with different location or shape(P>0.05). Also, there was no significant difference of CTA and DSA in the measurement of size, neck width and AR of the aneurysms.Conclusion:There was no significant difference between CTA and DSA in diagnosis of intracranial aneurysms. Part2Study of the rupture risk of intracranial aneurysms by CTAObjective:Assess the relationship between the morphological features and the risk of rupture of intracranial aneurysms by comparing CTA results of the ruptured and unruptured intracranial aneurysms.Methods:A retrospective analysis was carried out on the clinical data of108hospitalized patients with intracranial aneurysms during the period from January2010to December2012, in which82patients with ruptured aneurysms and26cases with unruptured aneurysms. CTA was used to measure the size, the neck width of the aneurysms and calculated the AR in order to comparative analyze the different in morphological features of ruptured and unruptured aneurysms.Result:The rupture rate of single aneurysms is75.0%and of multiple aneurysms is81.3%.There was no significant difference between these two rates(P>0.05). The rupture rates of saccular aneurysms and other forms of aneurysms were67.0%and52.9%. Also, there was no statistically significant difference between them(P>0.05). The rupture rates of intracranial aneurysms in different location is not the same (35.0%～77.4%), but there was no statistically significant difference between different groups (P>0.05). According to the independent sample t-test analysis, there was no statistically significant difference between the size, the neck width and the AR of ruptured and unruptured aneurysms(P>0.05). The rupture rates of aneurysms grouped by size into0～3mm,3mm～5mm and more than5mm were74.5%,59.2%and55.6%, but there was no significant difference (P>0.05) between these groups’ rupture rates. The rupture rates of aneurysms with the neck width<4mm and≥4mm were68%and54.5%and there was no statistically significant difference(P>0.05).According to the ROC curve analysis for the AR value, the results showed the optimal threshold was1.22.Conclusion:The rupture risk of multiple intracranial aneurysms and of single intracranial aneurysms is not different. The shape and the location of aneurysms are not related to the rupture risk. The size and the neck width of the aneurysms are not related to the rupture risk. AR=1.22may be the threshold of rupture of the aneurysms. The rupture risk of the aneurysms with AR≥1.22is higher than AR<1.22.