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目的探讨高分辨磁共振血管壁成像(high-resolusion magnetic resonance vessel wall imaging,HR-VWI)评估颅内动脉瘤的可行性。方法根据动脉瘤是否破裂,将接受HR-VWI检查的颅内动脉瘤分为破裂组(n=12)和未破裂组(n=88),对比两组动脉瘤的部位、大小、瘤颈宽度、高/颈比(aspect ratio,AR)、子囊和瘤壁强化等级。以动脉瘤是否破裂为因变量,以上各因素为自变量进行单因素和多因素Logistic回归分析。未破裂动脉瘤中,对症状性亚组(n=8)和无症状亚组(n=80)进行对比分析。结果破裂组的动脉瘤大小(t=2.187,P=0.031)、AR(t=3.164,P=0.002)、子囊比例(P=0.012)和瘤壁强化分级(P<0.001)大于未破裂组。多因素Logistic回归提示瘤壁强化等级是破裂动脉瘤的独立危险因素(P=0.002)。未破裂动脉瘤中,症状性亚组瘤壁强化分级(P<0.001)和AR(t=3.939,P<0.001)大于无症状亚组。结论破裂动脉瘤中HR-VWI瘤壁强化分级高于未破裂动脉瘤,症状性未破裂动脉瘤存在瘤壁强化现象。有必要获得瘤壁的组织学标本,与HR-VWI结果对照分析,进一步研究瘤壁强化的机制和意义。
Objective To evaluate the feasibility of evaluating intracranial aneurysms by high-resolution magnetic resonance vessel wall imaging (HR-VWI). Methods The intracranial aneurysms examined by HR-VWI were divided into ruptured group (n = 12) and non-ruptured group (n = 88) according to whether ruptured aneurysm. The location, size, , High ratio / aspect ratio (AR), ascoverage and tumor wall enhancement grade. To aneurysm rupture as the dependent variable, the above factors as independent variables univariate and multivariate logistic regression analysis. Unruptured aneurysms were compared between the symptomatic subgroup (n = 8) and the asymptomatic subgroup (n = 80). Results The ruptured aneurysm size (t = 2.187, P = 0.031), AR (t = 3.164, P = 0.002), ascus ratio (P = 0.012) and tumor wall enhancement grade (P <0.001) were higher than those without rupture. Multivariate logistic regression analysis revealed that aneurysm enhancement was an independent risk factor for ruptured aneurysm (P = 0.002). In the unruptured aneurysms, the symptomatic subgroups had a greater enhancement of tumor wall grade (P <0.001) and AR (t = 3.939, P <0.001) than the asymptomatic subgroups. Conclusion The ruptured aneurysms in HR-VWI tumor wall enhanced grading than unruptured aneurysm, there is tumor rupture in unruptured aneurysm phenomenon. It is necessary to obtain histological specimens of the tumor wall, and HR-VWI results and comparative analysis to further study the mechanism and significance of tumor wall enhancement.