医学
动脉瘤
后交通动脉
数字减影血管造影
逻辑回归
女儿
血管造影
放射科
临床意义
统计显著性
前交通动脉
条件logistic回归
解剖
内科学
置信区间
生物
进化生物学
作者
Jian Zhang,Anil Can,Pui Man Rosalind Lai,Srinivasan Mukundan,Víctor M. Castro,Dmitriy Dligach,Sean Finan,Vivian S. Gainer,Nancy A. Shadick,Guergana Savova,Shawn N. Murphy,Tianxi Cai,Scott T. Weiss,Rose Du
标识
DOI:10.1136/neurintsurg-2020-017062
摘要
Background Hemodynamic stress, conditioned by the morphology of the surrounding vasculature, plays an important role in aneurysm formation. Our goal was to identify image-based location-specific parameters that are associated with posterior communicating artery (PCoA) aneurysms. Methods Three-dimensional morphological parameters obtained from CT angiography or digital subtraction angiography from 187 patients with unilateral PCoA aneurysms, diagnosed at the Brigham and Women’s Hospital and Massachusetts General Hospital between 1990 and 2016, were evaluated. In order to control for genetic and clinical risk factors, we chose the contralateral unaffected PCoA as a control group. We examined diameters and angles of the surrounding parent and daughter vessels. Univariable and multivariable statistical analyses were performed to determine statistical significance. Sensitivity analyses with small aneurysms (≤5 mm) only and an unmatched analysis of 432 PCoA aneurysms and 197 control patients without PCoA aneurysms were also performed. Results In a multivariable conditional logistic regression model we showed that smaller diameter size ratio (OR 1.45×10 −5 , 95% CI 1.12×10 −7 to 1.88×10 −3 ) and larger daughter-daughter angle (OR 1.04, 95% CI 1.02 to 1.07) were significantly associated with PCoA aneurysm presence after correcting for other variables. In subgroup analyses of small aneurysms (≤5 mm) and in an unmatched analysis the significance and direction of these results were preserved. Conclusions Larger daughter-daughter angles and smaller diameter size ratio are significantly associated with the presence of PCoA aneurysms. These simple parameters can be utilized to guide the risk assessment for the formation of PCoA aneurysms in high risk patients.
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