Discriminators of Paraclinoid Aneurysm Rupture Based On Morphological Computer-Assisted Semiautomated Measurement (CASAM) and Hemodynamic Analysis.

IF 2.8 3区 医学 Q2 Medicine Clinical Neuroradiology Pub Date : 2024-12-04 DOI:10.1007/s00062-024-01475-3
Xiaodong Zhai, Sishi Xiang, Jiewen Geng, Peng Hu, Chuan He, Guilin Li, Jingwei Li, Liming Zhang, Wei Yang, Hongqi Zhang
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Abstract

Background: Paraclinoid aneurysms, arising from the proximal dural ring and extending to the origin of the posterior communicating artery of the internal carotid artery (ICA), represent a significant proportion of all intracranial aneurysms (IAs). Accurate prediction of the rupture risk of paraclinoid aneurysms is crucial for optimal management. The objective of this study was to identify risk factors for the rupture of paraclinoid aneurysms on the basis of computer-assisted semiautomated measurement (CASAM) and hemodynamics.

Methods: The clinical, demographic and radiological data of the 304 paraclinoid aneurysms (285 unruptured and 19 ruptured) included were extracted from the Chinese Intracranial Aneurysm Project (CIAP) database. Morphological parameters were quantified via CASAM, and hemodynamic simulations were performed via computational fluid dynamics (CFD). Univariate and multivariate logistic regression analyses were conducted to identify independent risk factors for aneurysm rupture.

Results: The mean age of the patients was 56.91 ± 11.0 years, with a female predominance (71.7%). Univariate analysis revealed that the undulation index (UI) and nonsphericity index (NSI) were significantly greater in ruptured paraclinoid aneurysms than in unruptured aneurysms. The proportion of ruptured paraclinoid aneurysms located laterally on the ICA was significantly lower than that of those located anteriorly (p = 0.002). Multivariate logistic regression analysis revealed that a greater UI (OR = 1.086, 95% CI 1.012-1.165; p = 0.022) and larger low shear area (LSA) (OR = 1.034, 95% CI 1.004-1.064; p = 0.028) were independent risk factors for rupture.

Conclusions: Our findings indicate that a greater UI and a larger LSA are independent risk factors for the rupture of paraclinoid aneurysms. Compared with aneurysms in other orientations, paraclinoid aneurysms located anteriorly to the ICA are more prone to rupture. These findings may be useful in developing more consummate predictive models to enhance the management and surveillance of paraclinoid aneurysms in the future, leading to improved clinical decision-making and better patient outcomes.

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基于形态计算机辅助半自动测量(CASAM)和血流动力学分析的类旁动脉瘤破裂鉴别。
背景:类旁动脉瘤起源于硬膜环近端并延伸至颈内动脉(ICA)后交通动脉的起点,在所有颅内动脉瘤(IAs)中占很大比例。准确预测线旁动脉瘤的破裂风险对优化治疗至关重要。本研究的目的是在计算机辅助半自动测量(CASAM)和血流动力学的基础上确定线旁动脉瘤破裂的危险因素。方法:从中国颅内动脉瘤项目(CIAP)数据库中提取304例类旁动脉瘤(未破裂285例,破裂19例)的临床、人口学和影像学资料。形态学参数通过CASAM进行量化,并通过计算流体动力学(CFD)进行血流动力学模拟。进行单因素和多因素logistic回归分析以确定动脉瘤破裂的独立危险因素。结果:患者平均年龄56.91 ±11.0岁,女性居多(71.7%)。单因素分析显示,破裂的类线旁动脉瘤的波动指数(UI)和非球形指数(NSI)明显高于未破裂的类线旁动脉瘤。腹旁动脉瘤位于ICA外侧的破裂比例明显低于位于ICA前方的破裂比例(p = 0.002)。多因素logistic回归分析显示,UI较高(OR = 1.086,95% CI 1.012-1.165;p = 0.022)和更大的低剪切面积(LSA) (OR = 1.034,95% CI 1.004-1.064;P = 0.028)是破裂的独立危险因素。结论:我们的研究结果表明,较大的UI和较大的LSA是类旁动脉瘤破裂的独立危险因素。与其他方位的动脉瘤相比,位于ICA前方的线旁动脉瘤更容易破裂。这些发现可能有助于开发更完善的预测模型,以加强对线旁动脉瘤的管理和监测,从而改善临床决策和患者预后。
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来源期刊
Clinical Neuroradiology
Clinical Neuroradiology Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
4.90
自引率
3.60%
发文量
0
期刊介绍: Clinical Neuroradiology provides current information, original contributions, and reviews in the field of neuroradiology. An interdisciplinary approach is accomplished by diagnostic and therapeutic contributions related to associated subjects. The international coverage and relevance of the journal is underlined by its being the official journal of the German, Swiss, and Austrian Societies of Neuroradiology.
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