CAJ | 학술논문

目的探讨前交通动脉动脉瘤(anterior communicating artery aneurysm,ACoAA)瘤体指向与大脑前动脉A1段几何形态学的关系.方法回顾性收集ACoAA患者的数字减影脑血管造影和临床资料.ACoAA依瘤体指向分为前下指向、前上指向、后上指向、后下指向和复杂指向型.大脑前动脉A1段根据其几何形态分为弧形(Ⅰa型:上弧形；Ⅰb型:下弧形)、“S”形(Ⅱa型:反横“S”形；Ⅱb型:横“S”形)、“近线”形(Ⅲa型:内侧半向下的“近线”形；Ⅲb型:内侧半朝上的“近线”形；Ⅲc型:基本水平状的“近线”形)及不显影.结果共纳入200例ACoAA患者,其中前上指向型93例,前下指向型76例,后下指向型8例,后上指向型8例,复杂指向型15例.大脑前动脉A1段形态分别为:Ⅰa型113侧,Ⅰb型8侧；Ⅱa型27侧,Ⅱb型70侧；Ⅲa型21侧,Ⅲb型46侧,Ⅲc型60侧；不显影55侧.ACoAA瘤体指向与优势显影侧A1段形态之间存在显著关联性(x2=215.582,P=0.000;Pearson列联系数C为o.665,P=0.000),与非优势显影侧A1段形态之间无显著关联性(x2=5.525,P=0.478).当ACoAA瘤体指向向下时,优势显影侧A1段一般表现为Ⅰa型、Ⅱa型或Ⅲa型；当瘤体指向向上时,优势显影侧A1段一般表现为Ⅰb型、Ⅱb型或Ⅲb型；当瘤体指向为复杂指向时,优势显影侧A1段可表现为各种形态.结论 ACoAA瘤体指向与优势显影侧大脑前动脉A1段形态之间存在显著关联性.
목적 탐토전교통동맥동맥류(anterior communicating artery aneurysm,ACoAA)류체지향여대뇌전동맥A1단궤하형태학적관계.방법 회고성수집ACoAA환자적수자감영뇌혈관조영화림상자료.ACoAA의류체지향분위전하지향、전상지향、후상지향、후하지향화복잡지향형.대뇌전동맥A1단근거기궤하형태분위호형(Ⅰa형:상호형；Ⅰb형:하호형)、“S”형(Ⅱa형:반횡“S”형；Ⅱb형:횡“S”형)、“근선”형(Ⅲa형:내측반향하적“근선”형；Ⅲb형:내측반조상적“근선”형；Ⅲc형:기본수평상적“근선”형)급불현영.결과 공납입200례ACoAA환자,기중전상지향형93례,전하지향형76례,후하지향형8례,후상지향형8례,복잡지향형15례.대뇌전동맥A1단형태분별위:Ⅰa형113측,Ⅰb형8측；Ⅱa형27측,Ⅱb형70측；Ⅲa형21측,Ⅲb형46측,Ⅲc형60측；불현영55측.ACoAA류체지향여우세현영측A1단형태지간존재현저관련성(x2=215.582,P=0.000;Pearson렬련계수C위o.665,P=0.000),여비우세현영측A1단형태지간무현저관련성(x2=5.525,P=0.478).당ACoAA류체지향향하시,우세현영측A1단일반표현위Ⅰa형、Ⅱa형혹Ⅲa형；당류체지향향상시,우세현영측A1단일반표현위Ⅰb형、Ⅱb형혹Ⅲb형；당류체지향위복잡지향시,우세현영측A1단가표현위각충형태.결론 ACoAA류체지향여우세현영측대뇌전동맥A1단형태지간존재현저관련성.
Objective To investigate the relationship between the dome direction of the anterior communicating artery aneurysm (ACoAA) and the geometric morphology of anterior cerebral artery A1 segnent.Methods The digital subtraction angiography and clinical data of the patients with ACoAA were collected retrospectively.According to the dome direction of the aneurysms,the ACoAA were divided into 5 types:anteroinferior direction,anterosuperior direction,posterosuperior direction,posteroinferior direction,and complex direction.According to the geometric morphology,the anterior cerebral artery A1 segment could be divided into "arc" pattern (type Ⅰ a:convex shape,type Ⅰ b:concave shape),"S" pattern (type Ⅱ a:inverse lateral "S"shape,type Ⅱb:lateral "S" shape),"approximate straight line" pattern (type Ⅲa:downward sloping "approximate straight line" shape,type Ⅲb:upward-sloping "approximate straight line" shape,type Ⅲc:horizontal "approximate straight line" shape) and non-development pattern.Results A total of 200 patients with ACoAA were enrolled in the study,93 in anterosuperior direction,76 in anteroinferior direction,8 in posteroinferior direction,8 in posterosuperior direction,and 15 in complex direction.The geometric morphology of the anterior cerebral artery A1 segment was as follows:type Ⅰ a (113 sides),type Ⅰ b (8 sides),type Ⅱ a (27 sides),type Ⅱb (70 side),type Ⅲa (21 side),type Ⅲb (46 sides),type Ⅲc (60 sides),and nondevelopment (55 sides).The dome direction of the ACoAA was significantly correlated with the geometric morphology of the anterior cerebral artery A1 segment in the dominant developing side (x2 =215.582,P =0.000; Pearson contingency coefficient C was 0.665,P =0.000).The dome direction of the ACoAA was not significantly correlated with geometric morphology of the anterior cerebral artery A1 segment in the non-dominant developing side (x2=5.525,P=0.478).When the ACoAA dome directed downward,the general performances of the A1 segment of the dominate developing side were type Ⅰ a,type Ⅱ a or type Ⅲa.When the ACoAAdome directed upward,the general performances of the A1 segment of the dominate developing side were type [b,type Ⅱ b or type Ⅲb.When the dome direction of the ACoAA was a complex one,the A1 segment of the dominate developing side might had different morphologies.Conelusions There is significant correlation between the dome direction of the ACoAA and the morphology of anterior cerebral artery A1 segments of the dominate developing side.